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Impact of pioglitazone on coronary endothelial function in non-diabetic patients with coronary artery disease

Jochen Wöhrle1, Nikolaus Marx, Wolfgang Koenig

  • 1Department of Internal Medicine II, University of Ulm, Ulm, Germany. jochen.woehrle@uniklinik-ulm.de

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|April 26, 2008
PubMed

Insights

Pioglitazone significantly improved coronary endothelial function in non-diabetic patients with coronary artery disease (CAD). This study found pioglitazone enhanced blood vessel response compared to placebo.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Pioglitazone demonstrates antiatherosclerotic effects beyond glycemic control.
  • Coronary artery disease (CAD) involves endothelial dysfunction.

Purpose of the Study:

  • To investigate if pioglitazone improves coronary endothelial dysfunction in non-diabetic CAD patients.
  • To assess pioglitazone's effects in a randomized, placebo-controlled trial.

Main Methods:

  • 50 non-diabetic CAD patients received pioglitazone or placebo for 6 months.
  • Coronary endothelial function assessed via intracoronary infusions (adenosine, acetylcholine, glyceroltrinitrate) and cold pressor test (CPT).
  • Primary endpoint: acetylcholine-induced coronary vascular response measured by quantitative coronary angiography.

Main Results:

  • No baseline differences in endothelial function.
  • Pioglitazone group showed a 1.8% increase in luminal area; placebo group showed a 7.6% decrease (P < 0.008).
  • A trend for improved CPT response in the pioglitazone group (P = 0.057).

Conclusions:

  • Pioglitazone treatment significantly improved coronary endothelial function in non-diabetic patients with CAD.
  • Results suggest pioglitazone has direct vascular benefits in CAD.
Abstract

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