Thiazolidinediones and risk for atherosclerosis: pleiotropic effects of PPar gamma agonism.
Despite advances in the development of anti-hyperglycaemic drugs and a greater focus on cardiovascular risk modification for patients with diabetes, cardiovascular disease remains the most common complication of type 2 diabetes. Since their initial availability in 1997, the thiazolidinediones have become one of the most commonly prescribed classes of medications for type 2 diabetes. In addition to glucose control, the thiazolidinediones have a number of pleiotropic effects on myriad traditional and non-traditional risk factors for cardiovascular disease, and hold promise with regard to modification of cardiovascular risk. In a recently reported large-scale clinical trial, pioglitazone was associated with improved cardiovascular outcomes in patients with type 2 diabetes and prevalent atherosclerotic disease. In this review, we summarise the experimental, preclinical and clinical data regarding the effects of the thiazolidinediones on cardiovascular risk factors and clinical outcomes.
Patel
Chetan B
CB
Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA.
De Lemos
James A
JA
Wyne
Kathleen L
KL
McGuire
Darren K
DK
D000818:Animals; D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000209:etiology; D002986:Clinical Trials as Topic; D048909:Diabetes Complications / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D050356:Lipid Metabolism / Q000187:drug effects; D047495:PPAR gamma / Q000819:agonists*; D045162:Thiazolidinediones / Q000494:pharmacology / Q000627:therapeutic use*
D047495:PPAR gamma; D045162:Thiazolidinediones