title: Effect of pioglitazone on endothelial dysfunction after sirolimus-eluting stent implantation.
abstract: Previous studies have demonstrated endothelial dysfunction after sirolimus-eluting stent (SES) implantation. The present study evaluated the effect of pioglitazone on endothelial dysfunction after SES implantation in nondiabetic patients. A total of 50 nondiabetic patients who had undergone SES implantation were randomly assigned to the pioglitazone group (n = 25) or the control group (n = 25). Endothelial function was estimated by measuring the coronary vasoreactivity in the reference segment within 15 mm proximal and distal to the SES in response to intracoronary acetylcholine infusion (10(-8) and 10(-7) mol/L) at 9 months of follow-up. Endothelium-independent vasomotion was assessed after an intracoronary bolus of nitroglycerin. Changes in the coronary diameter in response to 10(-8) and 10(-7) mol/L acetylcholine in the segment proximal to the SES were not significantly different between the pioglitazone and control groups. In contrast, in the segment distal to the SES, vasoconstrictions to 10(-8) (-3.0 ± 2.8% vs -7.1 ± 4.5%, p <0.01) and 10(-7) mol/L acetylcholine (-6.2 ± 8.0% vs -13.1 ± 8.9%, p <0.01) were attenuated in the pioglitazone group compared to the control group. Endothelium-independent vasodilation to nitrate did not differ between the 2 groups. Multivariate analysis showed that pioglitazone was an independent predictor improving endothelial dysfunction after SES implantation. In conclusion, pioglitazone might improve endothelial dysfunction after SES implantation in nondiabetic patients.
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kitahara
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Yo
authors.initials: Y
authors.lastname: Iwata
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000628:therapy; D003331:Coronary Vessels / Q000187:drug effects; D054855:Drug-Eluting Stents; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D015999:Multivariate Analysis; D000077205:Pioglitazone; D011446:Prospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D045162:Thiazolidinediones / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D014665:Vasodilator Agents; D000109:Acetylcholine; D020123:Sirolimus; D000077205:Pioglitazone