Pioglitazone reduces the necrotic-core component in coronary plaque in association with enhanced plasma adiponectin in patients with type 2 diabetes mellitus.
BACKGROUND
Pioglitazone has a preventive effect on cardiovascular disease, but its ability to stabilize coronary plaque is unknown.


RESULTS
A prospective, randomized trial was conducted in 54 patients with type 2 diabetes and stable angina pectoris, randomly assigned to either a pioglitazone group or control group. Non-culprit, angiographically mild-to-moderate obstructive lesions were examined with virtual histology intravascular ultrasound (VH-IVUS) at coronary intervention and 6 months later. In total, 42 lesions of 22 patients in the pioglitazone group and 44 lesions of 24 patients in the control group were analyzed. After 6 months, patients in the pioglitazone group had significantly improved blood sugar, high-sensitivity C-reactive protein, and plasma adiponectin levels. VH-IVUS analysis revealed that, although the total plaque-to-vessel volume was not changed in either group, the necrotic-core area had significantly decreased in the pioglitazone group (-4.6+/-5.9% vs 1.1+/-9.3%, P=0.001). There was a significant inverse correlation between the change in plasma adiponectin levels and the change in necrotic-core area (r=-0.46, P<0.0001).


CONCLUSIONS
Pioglitazone may stabilize coronary plaque by reducing the necrotic-core component, in association with enhanced plasma adiponectin levels.
Ogasawara
Daisuke
D
Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Shite
Junya
J
Shinke
Toshiro
T
Watanabe
Satoshi
S
Otake
Hiromasa
H
Tanino
Yusuke
Y
Sawada
Takahiro
T
Kawamori
Hiroyuki
H
Kato
Hiroki
H
Miyoshi
Naoki
N
Hirata
Ken-Ichi
K
D052242:Adiponectin / Q000097:blood*; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D000077205:Pioglitazone; D011446:Prospective Studies; D045162:Thiazolidinediones / Q000627:therapeutic use*; D018084:Ultrasonography, Interventional
D052242:Adiponectin; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D002097:C-Reactive Protein; D000077205:Pioglitazone