Korean Circ J.  2010 Dec;40(12):625-631. 10.4070/kcj.2010.40.12.625.

The Effects of Pioglitazone in Reducing Atherosclerosis Progression and Neointima Volume in Type 2 Diabetic Patients: Prospective Randomized Study With Volumetric Intravascular Ultrasonography Analysis

• You SH
• Kim BS
• Hong SJ
• Ahn CM
• Lim DS

• KMID: 2225160
• DOI: http://doi.org/10.4070/kcj.2010.40.12.625

Abstract

BACKGROUND AND OBJECTIVES
Pioglitazone has been known for its anti-atherogenic effects. We compared the effects of pioglitazone in reducing atherosclerosis progression and neointima volume in type 2 diabetic patients.
SUBJECTS AND METHODS
This was a prospective, randomized single-blinded, 8-month follow-up study. Patients with significant coronary artery stenosis were randomly assigned to either pioglitazone (n=19) or placebo (n=18) following zotarolimus-eluting stent (ZES) implantation. Intravascular ultrasonography of the culprit vessel was performed from 20 mm distal and proximal to the stent at baseline. and at 8-month, and volumetric analysis was performed. Changes in inflammation markers, insulin resistance and lipid profile were compared.
RESULTS
Changes in atherosclerosis progression from baseline in the pioglitazone group was significantly lower than that of the placebo group (0.06+/-0.73 vs. 1.16+/-1.41 mm3/mm, p=0.024, respectively), and neointima volume was significantly lower in the pioglitazone group compared to the placebo group (1.74+/-0.93 vs. 2.42+/-1.98 mm3/mm, p=0.007, respectively). Homeostatic model assessment-index, interleukin-6, and tumor necrosis factor-alpha levels were significantly lower in the pioglitazone group at 8 months. Adiponectin levels increased significantly only in the pioglitazone group. No significant differences in retinol binding protein-4 levels between the 2 groups were seen during the 8-month follow-up period.
CONCLUSION
Compared to placebo, pioglitazone was associated with significant reduction in atherosclerosis progression and neointima formation in type 2 diabetic patients with ZES implantation.

Keyword

Intravascular ultrasonography; Pioglitazone; Diabetes mellitus; Neointima

MeSH Terms

Adiponectin
Atherosclerosis
Coronary Stenosis
Diabetes Mellitus
Follow-Up Studies
Glycosaminoglycans
Humans
Inflammation
Insulin Resistance
Interleukin-6
Neointima
Prospective Studies
Stents
Thiazolidinediones
Tumor Necrosis Factor-alpha
Ultrasonography, Interventional
Vitamin A
Adiponectin
Glycosaminoglycans
Interleukin-6
Thiazolidinediones
Tumor Necrosis Factor-alpha
Vitamin A

Figure

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  Fig. 1 A: changes in neointima volume and atheroma volume during the 8 month follow-up period. B: changes in atheroma volume are further divided into segments 5 mm immediately proximal and distal to the stent, and 5 to 20 mm proximal and distal to the stent.

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