title: Effect of pretreatment with pioglitazone on reperfusion injury in diabetic patients with acute myocardial infarction.
abstract: BACKGROUND
  Pioglitazone (PIO) is a new class of anti-diabetic agent with an anti-inflammatory effect. In the experimental studies, pretreatment with PIO before ischemia/reperfusion reduced ischemia-reperfusion injury and myocardial infarct size. However, the clinical efficacy of this therapy in patients with acute myocardial infarction (AMI) remains unknown.
  
  
  RESULTS
  Three hundred and nineteen diabetic patients with ST-segment elevation AMI, treated with bare metal stent within 24h from the onset of AMI were examined. Myocardial blush grade, ST-segment resolution, peak creatine kinase (CK) level, and left ventricular ejection fraction (LVEF) were compared between PIO group (pretreatment with PIO [+]; n=26) and non-PIO group (pretreatment with PIO [-]; n=293). The PIO group showed a significantly higher incidence of blush score ≥ 2 and complete ST-segment resolution (blush score ≥ 2; 38% vs. 71%, P=0.04, ST-segment resolution; 44% vs. 71%, P=0.04). Besides, slow flow/no-reflow phenomenon and reperfusion arrhythmia did not occur in this group. Better improvement of LVEF and lower peak CK level was observed in this group, although these were not statistically significant (LVEF 48% vs. 41%, P=0.10, peak CK level 2,041 vs. 3,207, P=0.06).
  
  
  CONCLUSIONS
  Pretreatment with PIO in diabetic patients with AMI resulted in better myocardial perfusion with less reperfusion injury.
authors.affiliation: Department of Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kataoka
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Yagi
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kokubu
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Abe
authors.forename: Yoritaka
authors.initials: Y
authors.lastname: Otsuka
mesh_terms: D000368:Aged; D003402:Creatine Kinase / Q000097:blood; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D000077205:Pioglitazone; D013318:Stroke Volume / Q000187:drug effects; D045162:Thiazolidinediones / Q000008:administration & dosage*
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D003402:Creatine Kinase; D000077205:Pioglitazone