title: Pioglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with type 2 diabetes mellitus: an intravascular ultrasound scanning study.
abstract: BACKGROUND
  It has been reported that pioglitazone reduces neointimal hyperplasia after balloon-induced vascular injury in an experimental model.
  
  
  METHODS
  To determine whether pioglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with type 2 diabetes mellitus, we studied 44 stented lesions in 44 patients with diabetes mellitus who underwent successful coronary stent implantation. Study patients were randomized into 2 groups: the pioglitazone group (23 patients with 23 lesions) and the control group (21 patients with 21 lesions). All patients underwent serial quantitative coronary angiography and serial intravascular ultrasound scanning studies. With a motorized pullback system, multiple image slices within the stent were obtained at every 1 mm. The stent area and lumen area were measured, and the neointimal area was calculated. Measurements were averaged over the number of selected image slices. The neointimal index was calculated as the averaged neointimal area divided by the averaged stent area multiplied by 100 (%).
  
  
  RESULTS
  After 6 months of treatment, angiographic in-stent restenosis (17% vs 43%, respectively, P =.0994) and target lesion revascularization (13% vs 38%, respectively, P =.0835) were less frequent in the pioglitazone group than the control group; however, these differences did not reach significance. The intravascular ultrasound scanning study demonstrated that the neointimal index in the pioglitazone group was significantly smaller than that in the control group (28% +/- 9% vs 48% +/- 15%, respectively, P <.0001).
  
  
  CONCLUSIONS
  A serial intravascular ultrasound scanning assessment demonstrated that pioglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with type 2 diabetes mellitus.
authors.affiliation: Takagi Cardiology Clinic, Kyoto, Japan. tcardiol@qb4.so-net.ne.jp
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takagi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamamuro
authors.forename: Koichi
authors.initials: K
authors.lastname: Tamita
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamabe
authors.forename: Minako
authors.initials: M
authors.lastname: Katayama
authors.forename: Shin
authors.initials: S
authors.lastname: Mizoguchi
authors.forename: Motoaki
authors.initials: M
authors.lastname: Ibuki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tani
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Nagai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Shiratori
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Morioka
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D015607:Stents; D013844:Thiazoles / Q000494:pharmacology* / Q000627:therapeutic use; D045162:Thiazolidinediones; D017539:Tunica Intima / Q000187:drug effects* / Q000473:pathology; D018084:Ultrasonography, Interventional
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D008055:Lipids; D013844:Thiazoles; D045162:Thiazolidinediones; D000077205:Pioglitazone