Effect of pioglitazone on cardiometabolic profiles and safety in patients with type 2 diabetes undergoing percutaneous coronary artery intervention: a ... View Full Text


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Article Info

DATE

2018-02-27

AUTHORS

Atsushi Tanaka, Sho Komukai, Yoshisato Shibata, Hiroyoshi Yokoi, Yoshihiro Iwasaki, Tomohiro Kawasaki, Kenji Horiuchi, Koichi Nakao, Takafumi Ueno, Hitoshi Nakashima, Masahiro Tamashiro, Yutaka Hikichi, Mitsuhiro Shimomura, Motoko Tago, Shigeru Toyoda, Teruo Inoue, Atsushi Kawaguchi, Koichi Node, On behalf of the Pioglitazone Reduce Inflammation and Restenosis with and without Drug Eluting Stent (PRIDE) Study Investigators

ABSTRACT

Pioglitazone has superior antiatherosclerotic effects compared with other classes of antidiabetic agents, and there is substantial evidence that pioglitazone improves cardiovascular (CV) outcomes. However, there is also a potential risk of worsening heart failure (HF). Therefore, it is clinically important to determine whether pioglitazone is safe in patients with type 2 diabetes mellitus (T2DM) who require treatment for secondary prevention of CV disease, since they have an intrinsically higher risk of HF. This prospective, multicenter, open-label, randomized study investigated the effects of pioglitazone on cardiometabolic profiles and CV safety in T2DM patients undergoing elective percutaneous coronary intervention (PCI) using bare-metal stents or first-generation drug-eluting stents. A total of 94 eligible patients were randomly assigned to either a pioglitazone or conventional (control) group, and pioglitazone was started the day before PCI. Cardiometabolic profiles were evaluated before PCI and at primary follow-up coronary angiography (5–8 months). Pioglitazone treatment reduced HbA1c levels to a similar degree as conventional treatment (pioglitazone group 6.5 to 6.0%, P < 0.01; control group 6.5 to 5.9%, P < 0.001), without body weight gain. Levels of high-molecular weight adiponectin increased more in the pioglitazone group than the control group (P < 0.001), and the changes were irrespective of baseline glycemic control. Furthermore, pioglitazone significantly reduced plasma levels of natriuretic peptides and preserved cardiac systolic and diastolic function (assessed by echocardiography) without incident hospitalization for worsening HF. The incidence of clinical adverse events was also comparable between the groups. These results indicate that pioglitazone treatment before and after elective PCI may be tolerable and clinically safe and may improve cardiometabolic profiles in T2DM patients. More... »

PAGES

965-977

References to SciGraph publications

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  • Journal

    TITLE

    Heart and Vessels

    ISSUE

    9

    VOLUME

    33

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00380-018-1143-3

    DOI

    http://dx.doi.org/10.1007/s00380-018-1143-3

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1101243042

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29487991


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