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- Title
Improved Plaque Stability and Reduced Inflammation during Pioglitazone Treatment in Type 2 Diabetic Patients with CHD.
- Authors
Forst, Thomas; Lübben, Georg; Mushold, Petra; Karagiannis, Efstrathios; Kann, Peter; Pfützner, Andreas
- Abstract
Inflammation and plaque instability are important mediators of cardiovascular risk in patients with diabetes mellitus type 2. Matrix metalloproteinase 9 (MMP-9) is critically involved in plaque rupture and acute coronary syndromes. We investigated MMP-9 levels and inflammatory markers during pioglitazone treatment in type 2 diabetic with cardiovascular disease. In this multicenter, double blind study, eighty type 2 diabetic patients (68 men, 12 women; age (mean ± SD) 65.1.0±7.5 years, DM since 6.4±8.8 years) with angiographically proven CHD were randomly assigned to pioglitazone (PIO, 45 mg) or placebo (PLAC) treatment. At baseline and during a 28 days observational period MMP-9, MCP1, hsCRP, IL-6, sCD40, P-Selectin and TNF alpha were monitored. As shown in table 1, a significant reduction in MMP-9, MCP-1 and hsCRP levels could be found even after 1 week of PIO treatment. After one months, MCP-9 and hsCRP levels remained significantly lower during PIO compared to PLAC treatment (MMP-9: 329±165 vs. 398±132 ng/ml; hsCRP: 1.9±1.6 vs. 3.2±2.4 mg/l; p<0.05 respectively). A trend towards lowering of sCD40 could be observed during PIO treatment (1454±1701 vs. 922±994 pg/ml, p=0.09). No significant changes regarding IL6, P-Selectin, or TNF alpha could be found. HbaA1c was not different at baseline and did not change significantly during the investigation. In type 2 diabetic patients with increased cardiovascular risk, the anti-inflammatory and anti-atherogenic effects of pioglitazone appear quickly after the introduction of therapy.
- Subjects
INFLAMMATION; TYPE 2 diabetes; CARDIOVASCULAR diseases; PEOPLE with diabetes; CORONARY disease; METALLOPROTEINASES
- Publication
Diabetes, 2007, Vol 56, pA172
- ISSN
0012-1797
- Publication type
Article