title: PPARγ agonist use and recurrence of atrial fibrillation after successful electrical cardioversion.
abstract: Inflammation is associated with atrial fibrillation (AF), and peroxisome proliferator-activated receptor-gamma (PPARγ) agonists have anti-inflammatory properties. We tested whether pioglitazone reduced AF recurrence after electrical cardioversion (EC) by modifying systemic inflammation. In this randomized and prospective trial, patients with persistent AF and type 2 diabetes mellitus were randomized into a pioglitazone group (n=48) or a control group (n=49) before EC. Treatment was continued for 3 months or until AF recurred. Serum inflammatory markers [high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α)] were measured at baseline and follow-up. During the 3-month follow-up, AF recurred in 22 (45.8%) patients of the pioglitazone-treated and 24 (49.0%) patients of the control group (P=0.756). However, the 3 inflammatory markers were significantly lowered with pioglitazone treatment during follow-up. Cox proportional hazards regression models showed that the predictors of recurrence included AF history (relative risk RR 1.002, 95% CI 1.003-1.061, P =0.037) and the left atrial diameter (RR 1.131, 95% CI 1.029-1.242, P = 0.010). In conclusion, while reducing some inflammatory markers, the PPARγ agonist pioglitazone did not affect the recurrence of AF after EC.
authors.affiliation: Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China; Department of Cardiology, Shanghai Minhang Hospital, Fudan University, Shanghai, People's Republic of China. Electronic address: forrestgu@126.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Cardiology, Shanghai Minhang Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Cardiology, Shanghai Minhang Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Zhi-Ping
authors.initials: ZP
authors.lastname: Song
authors.affiliation: Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Shanghai Minhang Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Da-Dong
authors.initials: DD
authors.lastname: Zhang
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D047495:PPAR gamma / Q000819:agonists*; D000077205:Pioglitazone; D012008:Recurrence; D012189:Retrospective Studies; D045162:Thiazolidinediones / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D047495:PPAR gamma; D045162:Thiazolidinediones; D000077205:Pioglitazone
keywords: Atrial fibrillation; Electrical cardioversion; Inflammation; PPARγ agonist