Effects of low-dose pioglitazone on glucose control, lipid profiles, renin-angiotensin-aldosterone system and natriuretic peptides in diabetic patients with coronary artery disease.
BACKGROUND
Pioglitazone ameliorates insulin resistance, but has an adverse effect of oedema that may result in subsequent heart failure, especially in diabetic patients with coronary artery disease. In this study, we evaluated the effects of low-dose pioglitazone on glucose control, lipid profiles, renin-angiotensin-aldosterone (RAA) system and natriuretic peptides in diabetic patients with coronary artery disease.


METHODS
and results: We studied 22 diabetic patients with coronary artery disease and more than 40% of left ventricular ejection fraction (LVEF). Patients were treated with 15 mg of pioglitazone for 12 weeks, in addition to their other hypoglycaemic agents. Pioglitazone significantly decreased fasting blood glucose (155.2±52.9 mg/dl to 131.1±38.4 mg/dl, p<0.01) and haemoglobin A1C (7.13±0.44 to 6.69±0.47, p<0.001). It did not affect low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, but significantly decreased triglyceride (115.6±28.8 mg/dl to 99.4±30.0 mg/dl, p<0.05) and atherogenic index of plasma (0.28±0.17 to 0.19±0.16, p<0.05). Pioglitazone did not affect plasma renin activity, plasma aldosterone, human atrial natriuretic peptide or N-terminal pro-brain natriuretic peptide.


CONCLUSIONS
Our data suggested that low-dose pioglitazone was a safe and useful agent at least in diabetic patients with coronary artery disease and preserved LVEF.
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. skurisu@nifty.com
Satoshi
S
Kurisu
Toshitaka
T
Iwasaki
Ken
K
Ishibashi
Naoya
N
Mitsuba
Yoshihiro
Y
Dohi
Kenji
K
Nishioka
Yasuki
Y
Kihara
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D001835:Body Weight; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D045265:Natriuretic Peptides / Q000378:metabolism*; D000077205:Pioglitazone; D012084:Renin-Angiotensin System / Q000187:drug effects; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
D001786:Blood Glucose; D008055:Lipids; D045265:Natriuretic Peptides; D045162:Thiazolidinediones; D000077205:Pioglitazone