Document Detail


Effect of thiazolidinedione therapy on restenosis after coronary stent implantation: a meta-analysis of randomized controlled trials.
MedLine Citation:
PMID:  17584567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We sought to review the evidence from the available randomized controlled trials (RCTs) regarding the effect of thiazolidinedione therapy on in-stent restenosis after percutaneous coronary intervention. METHODS: The studies in our meta-analysis were retrieved from search on the PubMed database and from references in relevant articles. Included studies were RCTs that provided comparative data regarding the effectiveness of 6-month pioglitazone or rosiglitazone therapy on the prevention of in-stent restenosis after coronary stent implantation as assessed by quantitative coronary angiography. RESULTS: Five RCTs that included 235 evaluable patients who underwent coronary stent implantation and received a 6-month pioglitazone or rosiglitazone therapy were included in our meta-analysis. Restenosis rate was significantly lower in patients who received thiazolidinedione therapy in addition to standard therapy (3 RCTs, 170 patients, odds ratio 0.29, 95% CI 0.15-0.56, random effects model). Percentage diameter stenosis was significantly lower in the pioglitazone-rosiglitazone arm (3 RCTs, 170 patients, weighted difference in means 14.35, 95% CI 19.99-8.72, random effects model). Minimal lumen diameter of the target lesion was significantly higher in patients who received thiazolidinedione therapy (3 RCTs, 170 patients, weighted difference in means 0.43, 95% CI 0.21-0.65, random effects model). Patients who received thiazolidinediones were significantly less likely to undergo target lesion revascularization due to restenosis (4 RCTs, 197 patients, odds ratio 0.24, 95% CI 0.09-0.61, random effects model). CONCLUSIONS: Our study suggests that thiazolidinedione therapy in patients undergoing coronary stent implantation may be associated with less in-stent restenosis and repeated revascularization. Decisions on clinical use of this therapy must await larger double-blind clinical trials.
Authors:
Evangelos S Rosmarakis; Matthew E Falagas
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  American heart journal     Volume:  154     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-22     Completed Date:  2007-07-02     Revised Date:  2007-11-13    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  144-50     Citation Subset:  AIM; IM    
Affiliation:
Alfa Institute of Biomedical Sciences, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography
Coronary Restenosis / etiology,  prevention & control*,  radiography
Female
Follow-Up Studies
Humans
Hypoglycemic Agents / therapeutic use*
Male
Odds Ratio
Stents / adverse effects*
Thiazolidinediones / therapeutic use*
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Thiazolidinediones; 2295-31-0/2,4-thiazolidinedione
Comments/Corrections
Comment In:
Am Heart J. 2007 Nov;154(5):e41; author reply e43   [PMID:  17967579 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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