Effect of rosiglitazone on restenosis after coronary stenting in patients with type 2 diabetes.
BACKGROUND
Thiazolidinediones have been shown to have an antiproliferative vascular effect in experimental models. We sought to study the effect of rosiglitazone on in-stent restenosis in patients with established type 2 diabetes.


METHODS
Patients with treated type 2 diabetes (mean duration 5.5 +/- 7.5 years) referred for coronary stenting were randomized in a double-blind fashion to receive oral rosiglitazone or placebo for 6 months. Quantitative coronary angiography and intravascular ultrasound data were obtained at baseline and follow-up. Plasma plasminogen activator inhibitor-1 levels were prospectively measured.


RESULTS
Sixteen patients were enrolled. There were no significant differences in follow-up in-stent luminal diameter stenosis measured by quantitative coronary angiography or in-stent luminal area stenosis and neointimal volume index obtained by intravascular ultrasound, nor were there any differences in plasma plasminogen activator inhibitor-1 levels after long-term use despite improvement in diabetes control and insulin sensitivity.


CONCLUSIONS
Rosiglitazone, given at the time of stent implantation in treated diabetics, did not reduce in-stent restenosis in this small series. The vascular biological effects of this agent await further clarification in humans and evaluation in larger clinical trials.
Osman
Abdulfatah
A
Division of Cardiology, University of Texas Medical Branch, Galveston, Texas, USA.
Otero
Javier
J
Brizolara
Alberto
A
Waxman
Sergio
S
Stouffer
George
G
Fitzgerald
Peter
P
Uretsky
Barry F
BF
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood / Q000517:prevention & control* / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D003925:Diabetic Angiopathies / Q000517:prevention & control* / Q000601:surgery; D004311:Double-Blind Method; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D000077154:Rosiglitazone; D015607:Stents; D045162:Thiazolidinediones / Q000627:therapeutic use*
D002317:Cardiovascular Agents; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D017395:Plasminogen Activator Inhibitor 1; D000077154:Rosiglitazone; D045162:Thiazolidinediones