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Efficacy and safety of low-dose pioglitazone after primary coronary angioplasty with the use of bare metal stent in patients with acute myocardial infarction and with type 2 diabetes mellitus or impaired glucose tolerance

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Abstract

Thiazolidinediones (TZDs) have beneficial effects on markers of cardiovascular risk in patients with type 2 diabetes mellitus (DM). This study aimed to investigate the efficacy and safety of low-dose pioglitazone (15 mg per day) in patients with acute myocardial infarction (AMI) and type 2 DM or impaired glucose tolerance (IGT) treated with coronary angioplasty using bare metal stent (BMS). In 56 patients, pioglitazone was orally administered for 6 months after stenting (pioglitazone group). The incidence of in-stent restenosis (ISR) and left ventricular end-diastolic volume index (LVEDVI) at acute phase and 6 months after stenting in these patients were retrospectively compared with those in the other 37 patients (control group) treated without pioglitazone. No adverse events including death, emergency bypass surgery, and reinfarction, occurred in any patients in the hospital. There was no congestive heart failure (CHF) during a follow-up period in the pioglitazone group. At 6 months after stenting, the overall angiographic ISR rate was significantly lower in the pioglitazone group than in the control group (28.6% vs 48.6%, P = 0.049). In patients with hemoglobin A1c (HbA1c) <7.0% at follow-up, the ISR rate was also significantly lower in the pioglitazone group than in controls (21.3% vs 44.8%, P = 0.03). Delta-LVEDVI (defined as follow-up LVEDVI minus acute LVEDVI) was similar between the pioglitazone group and control group (0.13 vs 5.16 ml/m2, P = 0.482). Low-dose pioglitazone seems to have a potential to reduce ISR and does not adversely affect LV remodeling after AMI treated with coronary angioplasty using BMS in patients with type 2 DM or IGT.

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References

  1. DL Fischman MB Leon DS Baim (1994) ArticleTitleA randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease N Engl J Med 331 IssueID8 496–501 Occurrence Handle8041414 Occurrence Handle10.1056/NEJM199408253310802 Occurrence Handle1:STN:280:DyaK2czhs1amsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. JP Carrozza RE Kuntz RF Fishman (1993) ArticleTitleRestenosis after arterial injury caused by coronary stenting in patients with diabetes mellitus Ann Intern Med 118 IssueID5 344–349 Occurrence Handle8430980

    PubMed  Google Scholar 

  3. BD Klugherz DL DeAngelo BK Kim (1996) ArticleTitleThree-year clinical follow-up after Palmaz-Schatz stenting J Am Coll Cardiol 27 IssueID5 1185–1191 Occurrence Handle8609340 Occurrence Handle10.1016/0735-1097(95)00574-9 Occurrence Handle1:STN:280:DyaK287osFyntQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  4. A Kastrati A Schomig S Elezi (1997) ArticleTitlePredictive factors of restenosis after coronary stent placement J Am Coll Cardiol 30 IssueID6 1428–1436 Occurrence Handle9362398 Occurrence Handle10.1016/S0735-1097(97)00334-3 Occurrence Handle1:STN:280:DyaK1c%2Fis1Ohsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. KW Law Q He ZP Ding (1998) ArticleTitleMidterm angiographic outcome of single-vessel intracoronary stent placement in diabetic versus nondiabetic patients: a matched comparative study Am Heart J 136 IssueID1 150–155 Occurrence Handle10.1016/S0002-8703(98)70195-4

    Article  Google Scholar 

  6. R Kornowski GS Mintz KM Kent (1997) ArticleTitleIncreased restenosis in diabetes mellitus after coronary interventions is due to exaggerated intimal hyperplasia. A serial intravascular ultrasound study Circulation 95 IssueID6 1366–1369 Occurrence Handle9118501 Occurrence Handle1:STN:280:DyaK2s3jsVSjsQ%3D%3D

    PubMed  CAS  Google Scholar 

  7. GS Mintz R Mehran AJ Lansky (2000) ArticleTitleIncreased in-stent restenosis in diabetes is the combination of small vessel size and exaggerated initial hyperplasia J Am Coll Cardiol 35 IssueIDsuppl A 907

    Google Scholar 

  8. T Takagi A Yamamuro K Tamita (2003) ArticleTitlePioglitazone reduced neointimal tissue proliferation after coronary stent implantation in patients with type 2 diabetes mellitus: an intravascular ultrasound scanning study Am Heart J 146 IssueID2 E5 Occurrence Handle12891212 Occurrence Handle10.1016/S0002-8703(03)00146-7 Occurrence Handle1:CAS:528:DC%2BD3sXlvVCkt7w%3D

    Article  PubMed  CAS  Google Scholar 

  9. RW Nesto D Bell RO Bonow (2004) ArticleTitleThiazolidinedione use, fluid retention, and congestive heart failure: a consensus statement from the American Heart Association and American Diabetes Association Diabetes Care 27 IssueID1 256–263 Occurrence Handle14693998 Occurrence Handle10.2337/diacare.27.1.256 Occurrence Handle1:CAS:528:DC%2BD2cXmvV2isQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. S Aronoff S Rosenblatt S Braithwaite (2000) ArticleTitlePioglitazone hydrochloride monotherapy improves glycemic control in the treatment of patients with type 2 diabetes: a 6-month randomized placebo-controlled does-response study Diabetes Care 23 IssueID11 1605–1611 Occurrence Handle11092281 Occurrence Handle10.2337/diacare.23.11.1605 Occurrence Handle1:CAS:528:DC%2BD3cXot1ahsrw%3D

    Article  PubMed  CAS  Google Scholar 

  11. Y Miyazaki A Mahankali M Matsuda (2001) ArticleTitleImproved glycemic control and enhanced insulin sensitivity in type 2 diabetic subjects treated with pioglitazone Diabetes Care 24 IssueID4 710–719 Occurrence Handle11315836 Occurrence Handle10.2337/diacare.24.4.710 Occurrence Handle1:CAS:528:DC%2BD3MXivVOmur0%3D

    Article  PubMed  CAS  Google Scholar 

  12. MS Kipnes A Krosnick MS Rendell (2001) ArticleTitlePioglitazone hydrochloride in combination with sulfonylurea therapy improves glycemic control in patients with type 2 diabetes mellitus: a randomized, placebo-controlled study Am J Med 111 IssueID1 10–17 Occurrence Handle11448655 Occurrence Handle10.1016/S0002-9343(01)00713-6 Occurrence Handle1:CAS:528:DC%2BD3MXltVegsrg%3D

    Article  PubMed  CAS  Google Scholar 

  13. WT Friedewald RI Levy DS Fredrickson (1972) ArticleTitleEstimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge Clin Chem 18 IssueID6 499–502 Occurrence Handle4337382 Occurrence Handle1:CAS:528:DyaE38Xkslagsbw%3D

    PubMed  CAS  Google Scholar 

  14. S Goetze XP Xi H Kawano (1999) ArticleTitlePPAR gamma-ligands inhibit migration mediated by multiple chemoattractants in vascular smooth muscle cells J Cardiovasc Pharmacol 33 IssueID5 798–806 Occurrence Handle10226869 Occurrence Handle10.1097/00005344-199905000-00018 Occurrence Handle1:CAS:528:DyaK1MXislGgsbY%3D

    Article  PubMed  CAS  Google Scholar 

  15. M Igarashi Y Takeda N Ishibashi (1997) ArticleTitlePioglitazone reduces smooth muscle cell density of rat carotid arterial intima induced by balloon catheterization Horm Metab Res 29 IssueID9 444–449 Occurrence Handle9370113 Occurrence Handle1:CAS:528:DyaK2sXmvVOnurY%3D Occurrence Handle10.1055/s-2007-979074

    Article  PubMed  CAS  Google Scholar 

  16. M Igarashi A Hirata H Yamaguchi (2001) ArticleTitleCharacterization of an inhibitory effect of pioglitazone in balloon-injured vascular smooth muscle cell growth Metabolism 50 IssueID8 955–962 Occurrence Handle11474485 Occurrence Handle10.1053/meta.2001.24869 Occurrence Handle1:CAS:528:DC%2BD3MXlvVCksrs%3D

    Article  PubMed  CAS  Google Scholar 

  17. N Marx J Wohrle T Nusser (2005) ArticleTitlePioglitazone reduces neointima volume after coronary stent implantation: a randomized, placebo-controlled, double-blind trial in nondiabetic patients Circulation 112 IssueID18 2792–2798 Occurrence Handle16246947 Occurrence Handle10.1161/CIRCULATIONAHA.105.535484 Occurrence Handle1:CAS:528:DC%2BD2MXhtFCru7bF

    Article  PubMed  CAS  Google Scholar 

  18. RE Law S Goetze XP Xi (2000) ArticleTitleExpression and function of PPARgamma in rat and human vascular smooth muscle cells Circulation 101 IssueID11 1311–1318 Occurrence Handle10725292 Occurrence Handle1:CAS:528:DC%2BD3cXisVSqs7c%3D

    PubMed  CAS  Google Scholar 

  19. N Marx U Schonbeck MA Lazar (1998) ArticleTitlePeroxisome proliferator-activated receptor-gamma activators inhibit gene expression and migration in human vascular smooth muscle cells Circ Res 83 IssueID11 1097–1103 Occurrence Handle9831704 Occurrence Handle1:CAS:528:DyaK1cXnvFyqsLY%3D

    PubMed  CAS  Google Scholar 

  20. CH Wang N Ciliberti SH Li (2004) ArticleTitleRosiglitazone facilitates angiogenic progenitor cell differentiation toward endothelial lineage: a new paradigm in glitazone pleiotropy Circulation 109 IssueID11 1392–1400 Occurrence Handle14993120 Occurrence Handle10.1161/01.CIR.0000123231.49594.21

    Article  PubMed  Google Scholar 

  21. S Frantz K Hu J Widder (2004) ArticleTitlePeroxisome proliferator activated-receptor agonism and left ventricular remodeling in mice with chronic myocardial infarction Br J Pharmacol 141 IssueID1 9–14 Occurrence Handle14662734 Occurrence Handle10.1038/sj.bjp.0705585 Occurrence Handle1:CAS:528:DC%2BD2cXhsFaltbc%3D

    Article  PubMed  CAS  Google Scholar 

  22. T Shiomi H Tsutsui S Hayashidani (2002) ArticleTitlePioglitazone, a peroxisome proliferator-activated receptor-gamma agonist, attenuates left ventricular remodeling and failure after experimental myocardial infarction Circulation 106 IssueID24 3126–3132 Occurrence Handle12473562 Occurrence Handle10.1161/01.CIR.0000039346.31538.2C

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Hirosaki University School of Medicine, Zaifu-cho 5, Hirosaki, 036-8562, Japan

    Jin Yokoyama, Naoyuki Sutoh, Takumi Higuma, Daisuke Horiuchi, Chisato Katoh, Takashi Yokota, Takashi Echizen, Shingo Sasaki, Hiroyuki Hanada, Tomohiro Osanai & Ken Okumura

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  1. Jin Yokoyama
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  2. Naoyuki Sutoh
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  3. Takumi Higuma
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  6. Takashi Yokota
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  7. Takashi Echizen
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  8. Shingo Sasaki
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  10. Tomohiro Osanai
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  11. Ken Okumura
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Correspondence to Jin Yokoyama.

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Yokoyama, J., Sutoh, N., Higuma, T. et al. Efficacy and safety of low-dose pioglitazone after primary coronary angioplasty with the use of bare metal stent in patients with acute myocardial infarction and with type 2 diabetes mellitus or impaired glucose tolerance. Heart Vessels 22, 146–151 (2007). https://doi.org/10.1007/s00380-006-0951-z

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  • DOI: https://doi.org/10.1007/s00380-006-0951-z

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