BACKGROUND:Pioglitazone has a preventive effect on cardiovascular disease, but its ability to stabilize coronary plaque is unknown. METHODS AND RESULTS: A prospective, randomized trial was conducted in 54 patients with type 2 diabetes and stable angina pectoris, randomly assigned to either a pioglitazone group or control group. Non-culprit, angiographically mild-to-moderate obstructive lesions were examined with virtual histology intravascular ultrasound (VH-IVUS) at coronary intervention and 6 months later. In total, 42 lesions of 22 patients in the pioglitazone group and 44 lesions of 24 patients in the control group were analyzed. After 6 months, patients in the pioglitazone group had significantly improved blood sugar, high-sensitivity C-reactive protein, and plasma adiponectin levels. VH-IVUS analysis revealed that, although the total plaque-to-vessel volume was not changed in either group, the necrotic-core area had significantly decreased in the pioglitazone group (-4.6+/-5.9% vs 1.1+/-9.3%, P=0.001). There was a significant inverse correlation between the change in plasma adiponectin levels and the change in necrotic-core area (r=-0.46, P<0.0001). CONCLUSIONS:Pioglitazone may stabilize coronary plaque by reducing the necrotic-core component, in association with enhanced plasma adiponectin levels.
RCT Entities:
BACKGROUND:Pioglitazone has a preventive effect on cardiovascular disease, but its ability to stabilize coronary plaque is unknown. METHODS AND RESULTS: A prospective, randomized trial was conducted in 54 patients with type 2 diabetes and stable angina pectoris, randomly assigned to either a pioglitazone group or control group. Non-culprit, angiographically mild-to-moderate obstructive lesions were examined with virtual histology intravascular ultrasound (VH-IVUS) at coronary intervention and 6 months later. In total, 42 lesions of 22 patients in the pioglitazone group and 44 lesions of 24 patients in the control group were analyzed. After 6 months, patients in the pioglitazone group had significantly improved blood sugar, high-sensitivity C-reactive protein, and plasma adiponectin levels. VH-IVUS analysis revealed that, although the total plaque-to-vessel volume was not changed in either group, the necrotic-core area had significantly decreased in the pioglitazone group (-4.6+/-5.9% vs 1.1+/-9.3%, P=0.001). There was a significant inverse correlation between the change in plasma adiponectin levels and the change in necrotic-core area (r=-0.46, P<0.0001). CONCLUSIONS:Pioglitazone may stabilize coronary plaque by reducing the necrotic-core component, in association with enhanced plasma adiponectin levels.
Authors: Lawrence H Young; Catherine M Viscoli; Jeptha P Curtis; Silvio E Inzucchi; Gregory G Schwartz; Anne M Lovejoy; Karen L Furie; Mark J Gorman; Robin Conwit; J Dawn Abbott; Daniel L Jacoby; Daniel M Kolansky; Steven E Pfau; Frederick S Ling; Walter N Kernan Journal: Circulation Date: 2017-02-28 Impact factor: 29.690
Authors: Marit de Jong; H Bart van der Worp; Yolanda van der Graaf; Frank L J Visseren; Jan Westerink Journal: Cardiovasc Diabetol Date: 2017-10-16 Impact factor: 9.951
Authors: Karen L Walker; Daniel B Walsh; Philip P Goodney; Samantha A Connell; David H Stone; Richard J Powell; Eva M Rzucidlo Journal: BMC Cardiovasc Disord Date: 2014-12-11 Impact factor: 2.298
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