Effect of pioglitazone on cardiometabolic profiles and safety in patients with type 2 diabetes undergoing percutaneous coronary artery intervention: a prospective, multicenter, randomized trial

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 im...

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Published in:Heart and vessels 2018-09, Vol.33 (9), p.965-977
Main Authors: Tanaka, Atsushi, Komukai, Sho, Shibata, Yoshisato, Yokoi, Hiroyoshi, Iwasaki, Yoshihiro, Kawasaki, Tomohiro, Horiuchi, Kenji, Nakao, Koichi, Ueno, Takafumi, Nakashima, Hitoshi, Tamashiro, Masahiro, Hikichi, Yutaka, Shimomura, Mitsuhiro, Tago, Motoko, Toyoda, Shigeru, Inoue, Teruo, Kawaguchi, Atsushi, Node, Koichi
Format: Article
Language:English
Subjects:
Adiponectin
Angiography
Angioplasty
Antidiabetics
Biomedical Engineering and Bioengineering
Body weight
Body weight gain
Cardiac Surgery
Cardiology
Coronary artery
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Drug delivery
Echocardiography
Hafnium
Heart
Heart diseases
Implants
Intervention
Medical treatment
Medicine
Medicine & Public Health
Molecular weight
Original Article
Patients
Peptides
Pioglitazone
Plasma levels
Safety
Stents
Surgical implants
Vascular Surgery
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Summary: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  
ISSN:0910-8327
1615-2573
DOI:10.1007/s00380-018-1143-3