title: Pioglitazone induces regression and stabilization of coronary atherosclerotic plaques in patients with impaired glucose tolerance.
abstract: OBJECTIVE
  To observe the effects of pioglitazone on coronary plaque area, plaque burden, serum high-sensitivity C-reactive protein, adiponectin and plasma endothelin-1 levels in patients with impaired glucose tolerance and coronary borderline lesions.
  
  
  METHODS
  Thirty patients were randomly divided into two groups: a pioglitazone group and a control group. The latter was administered placebo in addition to standard therapy; the former pioglitazone 15 mg/d in addition to standard therapy. Before treatment and 6 months later, left ventricular ejection fraction, serum lipid profile, high-sensitivity C-reactive protein, adiponectin and plasma endothelin-1 levels were detected. Coronary plaque area and plaque burden were examined using intravascular ultrasound.
  
  
  RESULTS
  No significant differences were found in left ventricular ejection fraction and serum lipid levels pre- and post-trial. Compared with the control group, 6 months' treatment with pioglitazone significantly decreased coronary plaque burden (50.7 ± 11.1 vs. 64.1 ± 10.3%, P < 0.05), plaque area (6.22 ± 2.03 vs. 8.31 ± 4.29, P < 0.05), thin-cap fibroatheroma prevalence (11 vs. 22%, P < 0.05) and percentage of necrotic core area (16 ± 8 vs. 31 ± 7%, P < 0.05). Compared with the control group, serum high-sensitivity C-reactive protein and plasma endothelin-1 levels were significantly lower and adiponectin level significantly higher in patients in the pioglitazone group. Serum adiponectin level was negatively correlated with plasma endothelin-1 level and coronary plaque area (r = 0.739 and -0.431, respectively, both P < 0.05).
  
  
  CONCLUSIONS
  Pioglitazone may induce regression and stabilization of coronary atherosclerotic plaques. The mechanisms might involve inhibition of inflammation, increase in adiponectin level and improvement in endothelial function.
authors.affiliation: Department of Cardiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: H-B
authors.initials: HB
authors.lastname: Yang
authors.forename: X-Y
authors.initials: XY
authors.lastname: Zhao
authors.forename: J-Y
authors.initials: JY
authors.lastname: Zhang
authors.forename: Y-Y
authors.initials: YY
authors.lastname: Du
authors.forename: X-F
authors.initials: XF
authors.lastname: Wang
mesh_terms: D052242:Adiponectin / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control*; D011446:Prospective Studies; D012074:Remission Induction; D045162:Thiazolidinediones / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D052242:Adiponectin; D019332:Endothelin-1; D007004:Hypoglycemic Agents; D008055:Lipids; D045162:Thiazolidinediones; D002097:C-Reactive Protein; D000077205:Pioglitazone