|A prospective, multicenter, randomized trial to assess efficacy of pioglitazone on in-stent neointimal suppression in type 2 diabetes: POPPS (Prevention of In-Stent Neointimal Proliferation by Pioglitazone Study).|
|PMID: 19539256 Owner: NLM Status: MEDLINE|
|OBJECTIVES: The aim of this study was to clarify whether pioglitazone suppresses in-stent neointimal proliferation and reduces restenosis and target lesion revascularization (TLR) after percutaneous coronary intervention (PCI).
BACKGROUND: Previous single-center studies have demonstrated the anti-restenotic effect of a peroxisome proliferator-activated receptor gamma agonist, pioglitazone, after PCI.
METHODS: A total of 97 patients with type 2 diabetes mellitus (T2DM) undergoing PCI (bare-metal stents only) were enrolled. After PCI, patients were randomly assigned to either the pioglitazone group (n = 48) or the control group (n = 49). Angiographical and intravascular ultrasound (IVUS) imaging were performed at baseline and repeated at 6-month follow-up. Primary end points included angiographical restenosis and TLR at 6 months follow-up. Secondary end point was in-stent neointimal volume by IVUS.
RESULTS: Baseline glucose level and glycosylated hemoglobin (HbA1c) level were similar between the pioglitazone group and the control group. Angiographical restenosis rate was 17% in the pioglitazone group and 35% in control group (p = 0.06). The TLR was significantly lower in pioglitazone group than in control group (12.5% vs. 29.8%, p = 0.04). By IVUS (n = 56), in-stent neointimal volume at 6 months showed a trend toward smaller in the pioglitazone group than in the control group (48.0 +/- 30.2 mm(3) vs. 62.7 +/- 29.0 mm(3), p = 0.07). Neointimal index (neointimal volume/stent volume x 100) was significantly smaller in the pioglitazone group than in the control group (31.1 +/- 14.3% vs. 40.5 +/- 12.9%, p = 0.01).
CONCLUSIONS: Pioglitazone treatment might suppress in-stent neointimal proliferation and reduce incidence of TLR after PCI in patients with T2DM.
|Tsutomu Takagi; Hiroyuki Okura; Yoshiki Kobayashi; Toru Kataoka; Haruyuki Taguchi; Iku Toda; Koichi Tamita; Atsushi Yamamuro; Yuji Sakanoue; Akira Ito; Shiro Yanagi; Kenji Shimeno; Katsuhisa Waseda; Masao Yamasaki; Peter J Fitzgerald; Fumiaki Ikeno; Yasuhiro Honda; Minoru Yoshiyama; Junichi Yoshikawa;|
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|Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't|
|Title: JACC. Cardiovascular interventions Volume: 2 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2009 Jun|
|Created Date: 2009-06-22 Completed Date: 2009-08-27 Revised Date: 2014-09-05|
Medline Journal Info:
|Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States|
|Languages: eng Pagination: 524-31 Citation Subset: IM|
|APA/MLA Format Download EndNote Download BibTex|
Angioplasty, Balloon, Coronary / adverse effects, instrumentation*, mortality
Blood Glucose / drug effects
Cell Proliferation / drug effects
Coronary Restenosis / etiology, mortality, pathology, prevention & control*
Diabetes Mellitus, Type 2 / blood, complications, drug therapy*, mortality
Heart Diseases / etiology, prevention & control
Hemoglobin A, Glycosylated / metabolism
Hypoglycemic Agents / therapeutic use*
Myocardial Ischemia / drug therapy, etiology, mortality, therapy*
Thiazolidinediones / therapeutic use*
Tunica Intima / drug effects*, pathology
|0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/Metals; 0/Thiazolidinediones; 0/hemoglobin A1c protein, human; X4OV71U42S/pioglitazone|
|JACC Cardiovasc Interv. 2009 Jun;2(6):532-3
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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