Pioglitazone Trial: Summary
Among nondiabetic patients undergoing coronary stent implantation for de novo lesions, treatment with pioglitazone was associated with a reduction in neointima formation compared with treatment with placebo at 6 month follow-up.
The pioglitazone group also showed significant reductions in total plaque volume and stenosis at six months compared with the placebo group.
Past trials have shown pioglitazone to be associated with reduced rates of restenosis in diabetic patients. In this trial, there were no differences in change in fasting blood glucose, fasting insulin, HbA1c or lipid levels, suggesting that pioglitazone’s vessel wall benefits are unrelated to its role in regulating metobolic factors.
Consistent with this, previous studies have shown that glitazones interact with a vessel wall receptors, ultimately inhibiting neointima proliferation and reducing inflammation.
The sample size is of the trial is small (50), so while the results of the trial are promising, they will need to be validated by larger randomized trials with additional clinical endpoints.