Pioglitazone induces regression and stabilization of coronary atherosclerotic plaques in patients with impaired glucose tolerance

Diabetic Medicine, 03/01/2012

Yang HB et al. – Pioglitazone may induce regression and stabilization of coronary atherosclerotic plaques. The mechanisms might involve inhibition of inflammation, increase in adiponectin level and improvement in endothelial function.

Methods

  • Thirty patients were randomly divided into two groups: a pioglitazone group and a control group.
  • The latter was administered placebo in addition to standard therapy; the former pioglitazone 15mg/d in addition to standard therapy.
  • Before treatment and 6months later, left ventricular ejection fraction, serum lipid profile, high–sensitivity C–reactive protein, adiponectin and plasma endothelin–1 levels were detected.
  • Coronary plaque area and plaque burden were examined using intravascular ultrasound.

Results

  • No significant differences were found in left ventricular ejection fraction and serum lipid levels pre– and post–trial.
  • Compared with the control group, 6months' treatment with pioglitazone significantly decreased coronary plaque burden (50.7±11.1 vs. 64.1±10.3%, P<0.05), plaque area (6.22±2.03 vs. 8.31±4.29, P<0.05), thin–cap fibroatheroma prevalence (11 vs. 22%, P<0.05) and percentage of necrotic core area (16±8 vs. 31±7%, P<0.05).
  • Compared with the control group, serum high–sensitivity C–reactive protein and plasma endothelin–1 levels were significantly lower and adiponectin level significantly higher in patients in the pioglitazone group.
  • Serum adiponectin level was negatively correlated with plasma endothelin–1 level and coronary plaque area (r=0.739 and –0.431, respectively, both P<0.05).

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