| Reduction of neointimal hyperplasia after coronary stenting by pioglitazone in nondiabetic patients with metabolic syndrome. | |
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MedLine Citation:
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PMID: 17452150 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: This study investigates whether pioglitazone reduces neointimal hyperplasia after coronary stenting in nondiabetic patients with metabolic syndrome (MS) using intravascular ultrasound (IVUS). Pioglitazone, a novel insulin-sensitizing thiazolidinedione, has been shown to reduce neointimal hyperplasia after coronary stenting in patients with type 2 diabetes. However, the effect of pioglitazone on in-stent restenosis in nondiabetic patients with MS remains unknown. METHODS AND RESULTS: Twenty-eight nondiabetic patients with MS after bare-metal stent implantation were randomized to 6-month treatment with or without 30 mg/d of pioglitazone (pioglitazone group [PIO] of 14 patients with 16 lesions and control group [CONT] of 14 patients with 16 lesions). At baseline and at 6-month follow-up, assessment of insulin resistance and visceral fat accumulation, quantitative coronary angiographic analysis, and IVUS measurements were performed. Pioglitazone treatment improved insulin resistance and decreased visceral fat accumulation without significant changes in plasma glucose levels, glycosylated hemoglobin A1c levels, and lipid profiles. Intimal index (intimal area/stent area) and intimal area were reduced in PIO compared with CONT (13% +/- 7% vs 21% +/- 13%, P = .033; 1.28 +/- 0.76 mm2 vs 1.90 +/- 1.16 mm2, P = .084; respectively). Binary restenosis rate was 0% in PIO versus 31% in CONT (P = .043). CONCLUSIONS: This is the first randomized, prospective IVUS study demonstrating that pioglitazone reduces neointimal hyperplasia after coronary stenting in nondiabetic patients with MS. Our data suggest that pioglitazone treatment may represent a novel therapeutic tool to target in-stent restenosis in nondiabetic patients with MS. |
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Authors:
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Takuji Katayama; Hiroto Ueba; Ken Tsuboi; Norifumi Kubo; Takanori Yasu; Masatoshi Kuroki; Muneyasu Saito; Shin-ichi Momomura; Masanobu Kawakami |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American heart journal Volume: 153 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-04-24 Completed Date: 2007-05-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 762.e1-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Omiya Medical Center, Jichi Medical University, Saitama City, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Restenosis
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etiology,
prevention & control Coronary Vessels / pathology*, ultrasonography Female Follow-Up Studies Humans Hyperplasia / drug therapy, etiology, ultrasonography Hypoglycemic Agents / therapeutic use* Male Metabolic Syndrome X / complications, therapy* Middle Aged Stents* Thiazolidinediones / therapeutic use* Treatment Outcome Tunica Intima / pathology*, ultrasonography Ultrasonography, Interventional |
| Chemical | |
Reg. No./Substance:
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0/Hypoglycemic Agents; 0/Thiazolidinediones; 111025-46-8/pioglitazone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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