Peroxisome proliferator-activated receptor γ gene polymorphisms and restenosis in diabetic patients after stenting in coronary arteries

Excerpt

To the Editor: Although coronary artery stenting has been shown to reduce restenosis rates compared with balloon angioplasty, in-stent restenosis remains a significant clinical problem, especially in patients with diabetes mellitus [1]. Restenosis after stenting is mainly caused by exaggerated inflammatory reactions and neointima formation in response to mechanical injury of the arterial wall [2]. Combined evidence suggests that peroxisome proliferator-activated receptor γ (PPARγ), a transcription factor structurally related to the nuclear receptors for steroid and thyroid hormones, attenuates the progress of atherosclerotic lesion development and restrains restenosis because of its inhibitory effects on inflammatory cell activation and vascular smooth muscle cell migration and proliferation [3, 4]. In support of this suggestion, it was reported that treatment of diabetic patients with the troglitazone, a PPARγ activator, interferes with neointima formation after coronary artery stenting [5]. …