OBJECTIVE:Pioglitazone has been shown to exert multiple antiatherosclerotic actions independent from its glycemic effects. We studied the hypothesis that pioglitazone improves coronary endothelial dysfunction in non-diabetic patients with coronary artery disease (CAD) in a randomized, placebo-controlled, double-blind trial. METHODS:Fifty non-diabetic patients with CAD were randomized to 6 months treatment with pioglitazone 30 mg daily or placebo. Coronary endothelial function was tested at baseline and after 6 months with intracoronary infusion of adenosine, acetylcholine (0.072; 0.72; 7.2, and 36 microg/min), glyceroltrinitrate, and cold pressor test (CPT). The primary endpoint was the mean effect of treatment compared with placebo on acetylcholine-induced coronary vascular response for all acetylcholine dosages, based on percent change in luminal area measured by quantitative coronary angiography. RESULTS: There was no difference in baseline coronary endothelial function. The primary endpoint was significantly different between the groups with a 1.8% +/- 2.0% increase in luminal area between baseline and follow-up with pioglitazone and a 7.6% +/- 2.4% decrease in the placebo group (P < 0.008). At follow-up, there was a trend for a difference in CPT (P = 0.057). No difference was observed regarding intracoronary glyceroltrinitrate or adenosine. CONCLUSIONS:Pioglitazone treatment in non-diabetic patients with CAD was associated with a significantly better coronary endothelial function compared to placebo.
RCT Entities:
OBJECTIVE:Pioglitazone has been shown to exert multiple antiatherosclerotic actions independent from its glycemic effects. We studied the hypothesis that pioglitazone improves coronary endothelial dysfunction in non-diabeticpatients with coronary artery disease (CAD) in a randomized, placebo-controlled, double-blind trial. METHODS: Fifty non-diabeticpatients with CAD were randomized to 6 months treatment with pioglitazone 30 mg daily or placebo. Coronary endothelial function was tested at baseline and after 6 months with intracoronary infusion of adenosine, acetylcholine (0.072; 0.72; 7.2, and 36 microg/min), glyceroltrinitrate, and cold pressor test (CPT). The primary endpoint was the mean effect of treatment compared with placebo on acetylcholine-induced coronary vascular response for all acetylcholine dosages, based on percent change in luminal area measured by quantitative coronary angiography. RESULTS: There was no difference in baseline coronary endothelial function. The primary endpoint was significantly different between the groups with a 1.8% +/- 2.0% increase in luminal area between baseline and follow-up with pioglitazone and a 7.6% +/- 2.4% decrease in the placebo group (P < 0.008). At follow-up, there was a trend for a difference in CPT (P = 0.057). No difference was observed regarding intracoronary glyceroltrinitrate or adenosine. CONCLUSIONS:Pioglitazone treatment in non-diabeticpatients with CAD was associated with a significantly better coronary endothelial function compared to placebo.
Authors: Fabrice M A C Martens; Frank L J Visseren; Eelco J P de Koning; Ton J Rabelink Journal: J Cardiovasc Pharmacol Date: 2005-12 Impact factor: 3.105
Authors: T Forst; C Hohberg; S D Fuellert; G Lübben; T Konrad; M Löbig; M M Weber; C Sachara; V Gottschall; A Pfützner Journal: Horm Metab Res Date: 2005-08 Impact factor: 2.936
Authors: M R Langenfeld; T Forst; C Hohberg; P Kann; G Lübben; T Konrad; S D Füllert; C Sachara; A Pfützner Journal: Circulation Date: 2005-05-09 Impact factor: 29.690