HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Riche, D. M. Articles by Henyan, N. N. Search for Related Content PubMed PubMed Citation Articles by Riche, D. M. Articles by Henyan, N. N. Social Bookmarking                What's this?

Thiazolidinediones and Risk of Repeat Target Vessel Revascularization Following Percutaneous Coronary Intervention

A meta-analysis

¹ University of Mississippi School of Pharmacy, Jackson, Mississippi
² University of Mississippi Medical Center, Jackson, Mississippi

Address correspondence and reprint requests to Nickole N. Henyan, PharmD, Assistant Professor, University of Mississippi School of Pharmacy, Department of Pharmacy Practice, University of Mississippi Medical Center, Office Annex Building, WW 116, 2500 North State St., Jackson, MS 39216. E-mail: nhenyan{at}sop.umsmed.edu

ABSTRACT

OBJECTIVE—Thiazolidinediones (TZDs) (rosiglitazone and pioglitazone) are a class of antidiabetes agents that have a high affinity for peroxisome proliferator–activated receptor-. TZDs initiate a multitude of physiologic processes that may elicit benefits as systemic agents for the prevention of restenosis requiring revascularization following percutaneous coronary intervention (PCI). Numerous trials have evaluated the impact of TZDs on repeat target vessel revascularization (TVR) in patients following PCI; however, several limitations (small sample size, inconclusive results, and risk factor stratification) complicate definitive conclusions. A meta-analysis was performed to evaluate the impact of TZDs on repeat TVR following PCI.

RESEARCH DESIGN AND METHODS—Included trials met the following criteria: 1) prospective, randomized controlled trials evaluating available TZDs versus standards of care; 2) well-described protocol; 3) minimum of 6 months of follow-up; and 4) data provided on repeat TVR. Data are presented as relative risks (RRs) with 95% CIs.

RESULTS—Seven clinical trials (n = 608) met the inclusion criteria. Upon meta-analysis, the risk of repeat TVR was significantly reduced in patients who received TZD therapy compared with standards of care (RR 0.35 [95% CI 0.22–0.57]). In studies using rosiglitazone (0.45 [0.25–0.83]) and pioglitazone (0.24 [0.11–0.51]), risk of repeat TVR was significantly reduced. Risk of repeat TVR was also significantly reduced among patients with (0.34 [0.19–0.63]) and without (0.37 [0.18–0.77]) diabetes.

CONCLUSIONS—Results from this meta-analysis suggest that TZDs effectively reduce the risk of repeat TVR following PCI.

Abbreviations: PCI, percutaneous coronary intervention • PPAR, peroxisome proliferator–activated receptor • TVR, target vessel revascularization • TZD, thiazolidinedione • VSMC, vascular smooth muscle cell

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				Z. T. Bloomgarden Approaches to Treatment of Type 2 Diabetes Diabetes Care, August 1, 2008; 31(8): 1697 - 1703. [Full Text] [PDF]

				D. M. Riche and K. M. Dale A Perspective on Coronary Revascularization in the PROactive 05 Study J. Am. Coll. Cardiol., October 23, 2007; 50(17): 1705 - 1706. [Full Text] [PDF]

				Z. T. Bloomgarden The Avandia Debate Diabetes Care, September 1, 2007; 30(9): 2401 - 2408. [Full Text] [PDF]