PPARgamma agonists and coronary atherosclerosis.
The prevalence of type 2 diabetes mellitus (T2DM) is growing at an alarming rate and reaching epidemic proportions, and cardiovascular disease continues to be one of the leading causes of death in the United States. The key relationship between these two diseases (knowing that T2DM is a strong risk factor for cardiovascular disease) is insulin resistance and the detrimental effect it has on macrovasculature. Thiazolidinediones (TZDs) are peroxisome proliferator-activated receptor gammaagonists that are beneficial in the treatment of T2DM and have the added benefit of modifying lipid profiles. This review discusses the basic science linking insulin resistance to atherosclerosis and describes the major TZD trials in the recent literature. It also addresses the clinical implications of these studies and media scrutiny surrounding the recent controversial report that TZDs may be linked to an increased risk of myocardial infarction.
Sulistio
Melanie S
MS
University of Texas Health Science Center at San Antonio, Department of Cardiology, 7300 Medical Drive, San Antonio, TX 78229, USA. sulistio@uthscsa.edu
Zion
Adrienne
A
Thukral
Nandish
N
Chilton
Robert
R
D000818:Animals; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000503:physiopathology*; D023903:Coronary Restenosis / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D003925:Diabetic Angiopathies / Q000188:drug therapy; D005230:Fatty Acids, Nonesterified / Q000097:blood / Q000502:physiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007333:Insulin Resistance / Q000502:physiology; D047495:PPAR gamma / Q000037:antagonists & inhibitors*; D000077205:Pioglitazone; D016032:Randomized Controlled Trials as Topic; D000077154:Rosiglitazone; D015607:Stents; D045162:Thiazolidinediones / Q000494:pharmacology / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
D005230:Fatty Acids, Nonesterified; D007004:Hypoglycemic Agents; D047495:PPAR gamma; D045162:Thiazolidinediones; D014280:Triglycerides; D000077154:Rosiglitazone; D000077205:Pioglitazone