Abstract 979: Pioglitazone Reduces Chemokine Receptor 2 Expressions on CD14+ Cells, Circulating Natural Killer Cells, and Neointima Volume in Type 2 Diabetic Patients
Background: Pioglitazone has been known for its anti-atherogenic and anti-inflammatory effects. We compared the effects of pioglitazone in reducing chemokine receptor (CCR) 2 expressions on CD14+ cells, natural killer (NK) cells, and neointima volume during the 8 months follow-up in type 2 diabetic patients.
Methods: Type 2 diabetic patients with significant coronary artery stenosis were randomly assigned to either pioglitazone (n=47) or placebo (n=47) after zotarolimus-eluting stent (ZES) implantation. Intravascular ultrasonography at culprit vessel was performed from 10mm distal and proximal to the stent at baseline and at 8-month, and volumetric analysis was performed. Serial changes in the number of NK cells and inflammatory markers were compared.
Results: Changes in atherosclerosis progression from baseline in the Pioglitazone Group was significantly lower than that of the Placebo Group for both the proximal segment to the stent (−0.3±2.7 vs. 1.0±1.8 mm3/mm, p=0.035, respectively) and for the distal segment to the stent (0.1±1.6 vs. 1.4±2.5 mm3/mm, p=0.023, respectively). Neointima volume was significantly lower in the Pioglitazone Group compared with the Placebo Group (1.3±0.7 vs. 2.5±1.4 mm3/mm, p<0.001, respectively). NK cells decreased significantly in the Pioglitazone Group when compared to the Placebo Group 2 days after stenting (326±101 vs. 563±134, p=0.008, respectively). CCR 2 expressions on CD14+ cells decreased 20% from baseline in the Pioglitazone Group and increased 50% in the Placebo Group 2 days after stenting. Changes in tumor necrosis factor-α (−3.2±2.7 vs. −0.4±1.1 pg/mL, p<0.05, respectively) and IL-6 levels (−0.7±1.0 vs. −0.1±0.9 pg/mL, p=0.05, respectively) were significantly lower in the Pioglitazone Group when compared to the Placebo Group.
Conclusion: Pioglitazone, when compared to the placebo, was associated with a significant reduction in NK cells, CCR 2 expression on circulating CD14+ cells, and neointima volume in type 2 diabetic patients with ZES implantation.