Pioglitazone Reduces the Necrotic-Core Component in Coronary Plaque in Association With Enhanced Plasma Adiponectin in Patients With Type 2 Diabetes Mellitus

Daisuke Ogasawara; Junya Shite; Toshiro Shinke; Satoshi Watanabe; Hiromasa Otake; Yusuke Tanino; Takahiro Sawada; Hiroyuki Kawamori; Hiroki Kato; Naoki Miyoshi; Ken-ichi Hirata

doi:10.1253/circj.CJ-08-0699

Ischemic Heart Disease

Pioglitazone Reduces the Necrotic-Core Component in Coronary Plaque in Association With Enhanced Plasma Adiponectin in Patients With Type 2 Diabetes Mellitus

Daisuke Ogasawara, Junya Shite, Toshiro Shinke, Satoshi Watanabe, Hiromasa Otake, Yusuke Tanino, Takahiro Sawada, Hiroyuki Kawamori, Hiroki Kato, Naoki Miyoshi, Ken-ichi Hirata

Author information

Daisuke Ogasawara
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Junya Shite
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Toshiro Shinke
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Satoshi Watanabe
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Hiromasa Otake
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Yusuke Tanino
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Takahiro Sawada
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Hiroyuki Kawamori
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Hiroki Kato
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Naoki Miyoshi
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
Ken-ichi Hirata
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine

Keywords: Adiponectin, Diabetes mellitus, Intravascular ultrasound, Pioglitazone, Virtual histology

JOURNAL FREE ACCESS

2009 Volume 73 Issue 2 Pages 343-351

DOI https://doi.org/10.1253/circj.CJ-08-0699

View "Advance Publication" version (December 18, 2008).

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Abstract

Background Pioglitazone has a preventive effect on cardiovascular disease, but its ability to stabilize coronary plaque is unknown. Methods and Results A prospective, randomized trial was conducted in 54 patients with type 2 diabetes and stable angina pectoris, randomly assigned to either a pioglitazone group or control group. Non-culprit, angiographically mild-to-moderate obstructive lesions were examined with virtual histology intravascular ultrasound (VH-IVUS) at coronary intervention and 6 months later. In total, 42 lesions of 22 patients in the pioglitazone group and 44 lesions of 24 patients in the control group were analyzed. After 6 months, patients in the pioglitazone group had significantly improved blood sugar, high-sensitivity C-reactive protein, and plasma adiponectin levels. VH-IVUS analysis revealed that, although the total plaque-to-vessel volume was not changed in either group, the necrotic-core area had significantly decreased in the pioglitazone group (-4.6±5.9% vs 1.1±9.3%, P=0.001). There was a significant inverse correlation between the change in plasma adiponectin levels and the change in necrotic-core area (r=-0.46, P<0.0001). Conclusions Pioglitazone may stabilize coronary plaque by reducing the necrotic-core component, in association with enhanced plasma adiponectin levels. (Circ J 2009; 73: 343 - 351)

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