Abstract 3637: Pioglitazone Decreases Carotid Intima-media Thickness Independently of Glycemic Control in Patients of Coronary Artery Disease with Impaired Glucose Tolerance
BACKGROUND: Impaired glucose tolerance is known to cause atherosclerosis and poor mortality. Pioglitazone have been reported to have anti-inflammatory and potential antiathero-genic effects for type 2 diabetes patients. But it is not clear whether pioglitazone demonstrates these effects also for impaired glucose tolerance (IGT) patients. The aim of this study was to investigate the effects of treatments with pioglitazone on atherosclerosis assessed by carotid intima-media thickness(IMT) in patients of coronary artery disease (CAD) with IGT.
MEHTODS: All subjects were admitted due to coronary artery disease and performed percutaneous coronary intervention. Eligible subjects were men who had no history of diabetes, fasting glucose <126mg/dl, and impaired glucose tolerance according to an oral glucose tolerance test. They were randomized to pioglitazone-treated group (15 mg daily) or untreated control group. The changes in glycolipid metabolism, high sensitivity C-reactive peptide (HSCRP) and carotid IMT (B-mode ultrasonography) were analyzed at baseline and after 6 months of therapy.
RESULTS: Baseline data were similar between two groups. They also received equal medical treatment including statins and anti-hypertnesive drugs. The pioglitazone treatment significantly reduced IMT (−0.08+/−0.15 v.s.0.07+/−0.24: p=0.02). It also significantly decreased sigma-insulin value (242+/−95 v.s. 333+/−153: p=0.03) and HSCRP (0.04+/−0.04 v.s. 0.21+/−0.25: p=0.01). But there were no significant difference with glucose values in both groups (sigma glucose were 610+/−164 v.s. 614+/−96: p=0.94).
CONCLUSINS: We found substantial regression of carotid IMT, independent of improvement of glycemic control, after 6 months of pioglitazone treatment. This finding may have important prognostic implications for patients with IGT.