BackgroundThiazolidinediones(TZDs)notonlyimproveinsulinresistance,loweringbloodsugar,alsohasanti-atheroscleroticeffect.However,whethertheprotectiveeffectoncardiovascularpioglitazoneisstillcontroversial.MethodsTotally98patientswithcoronarydiseaseanddiabetesmellituswererandomlypidedintopioglitazonegroup(n=48)receivingconventionaltherapyandpioglitazone(15mg/day),andcontrolgroup(n=50)merelyreceivingconventionaltherapy.Thepatientswerefollowedupfor12months.TheplasmalevelofPlasminogenactivatorInhibitor1(PAI-1)andP-selectinweredetectedatbaselineandaftertreatmentfor12monthsbyELISA,andmajoradversecardiacevents(MACE)werestudied.ResultsPioglitazonetherapyfor12monthswasassociatedwithasignificantdecreaseofPAI-1[(7.9±1.4vs4.2±0.5)ng/mL,P<0.05]andP-selectin[(16.6±6.8vs12.4±3.6)ng/mL,P<0.05],MACEwassignificantlylowerinthepioglitazonegroupthaninthecontrolgroup[acutecoronarysyndrome(ACS):32.0%vs10.4%,P<0.05;targetvesselrevascularization:22.0%vs6.3%,P<0.05].ConclusionsPioglitazonecaneffectivelyreducetheplasmalevelofPAI-1,P-selectinandtheoccurrenceofMACEinpatientswithcoronaryheartdiseaseanddiabetesmellitus.
