Abstract 16505: Pioglitazone Attenuates Atherosclerotic Plaque Inflammation in Impaired Glucose Tolerance -Evaluation by Serial 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography-
Background: PROactive study demonstrated that pioglitazone remarkably reduced the incidence of stroke. It was possible that pioglitazone stabilized carotid plaque because of its anti-inflammatory properties, Resultsing in the decrease in stroke. But there are no reports that reveal in its causation. We reported with 18F-Fluorodeoxyglucose (FDG) -Positron Emission Tomography/Computed Tomography (PET/CT) that we were able to visual vascular inflammation and to monitor therapeutic response. Purpose:To assess whether 4-month pioglitazone therapy could attenuate atherosclerotic plaque inflammation by using serial FDG-PET/CT imaging in patients with impaired glucose tolerance (IGT).
Methods and Results: Forty-nine patients with IGT (68±8 years of age; 37 males, 12 females), who underwent hybrid PET/CT and had arterial FDG uptake, were randomized to receiving pioglitazone group (n=30) or receiving glimepiride group (n=19) for 4-month. We excluded patients with uncontrolled diabetes mellitus (fasting blood glucose >200mg/dL), with left ventricular dysfunction (left ventricular ejection fraction <40%) or heart failure (NYHA functional class >II) and with active inflammatory disease. Arterial FDG uptake was quantified by target-to-background ratio (TBR). After 4 months both interventions equally reduced HbA1c (ΔHbA1c, -0.41±0.43 vs -0.30±0.34%, n.s.), and no significant differences in blood pressure and serum LDL cholesterol level between pioglitazone therapy and glimepiride therapy. There were significantly greater reductions in hsCRP and TBR with pioglitazone than with glimepiride (ΔhsCRP, -0.27±0.48 vs 0.22±0.30mg/L, p=0.001; ΔTBR, -0.16±0.25 vs 0.07±0.34, p=0.008,Figure1).
Conclusions: Our findings suggest that pioglitazone has an anti-inflammatory effect on carotid atherosclerotic plaques, independently of its glucose lowing effect.
- © 2010 by American Heart Association, Inc.