Rapid improvement of carotid plaque echogenicity within 1 month of pioglitazone treatment in patients with acute coronary syndrome
Rapid improvement of carotid plaque echogenicity within 1 month of pioglitazone treatment in patients with acute coronary syndrome
复制标题
DOI：
10.1016/j.atherosclerosis.2008.07.023
复制
发表时间：
2009-04-01
期刊：
影响因子：
5.3
通讯作者：
Kugiyama, Kiyotaka
中科院分区：
文献类型：
--
作者：
Hirano, Mitsumasa;Nakamura, Takamitsu;Kugiyama, Kiyotaka
目的：本研究通过对急性冠状动脉综合征（ACS）和2型糖尿病（DM）患者颈动脉斑块回声的超声评价，探讨了吡格列酮（过氧化物酶体增殖物激活受体γ激动剂）是否可以稳定易损斑块。方法和结果：随机分配吡格列酮（15或30 mg/d，n = 31）或安慰剂（n = 30）治疗61例2型糖尿病合并颈动脉回声斑块患者，并在ACS发作后5天内开始治疗。在治疗开始前、治疗开始后2周、1个月和6个月，通过颈动脉超声背向散射积分（IBS）测量斑块回声，评估颈动脉易损斑块。IBS值的增加反映了颈动脉斑块回声增强。吡格列酮组颈动脉回声斑块的校正IBS值（内膜-中膜IBS值减去外膜IBS值）在治疗后2周没有变化，但在治疗后1个月显著增加，而安慰剂组没有。校准IBS值的增加与吡格列酮对CD 400的影响无显著相关性。结论：吡格列酮在ACS和2型糖尿病患者治疗开始后1个月内迅速改善颈动脉斑块回声。(C)2008爱思唯尔爱尔兰有限公司保留所有权利。
Objective: This Study examined whether pioglitazone, an agonist of peroxisome proliferator-activated receptor gamma, may stabilize vulnerable plaque with use of ultrasound evaluation of carotid artery plaque echolucency in patients with acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM).Methods and results: Treatment with pioglitazone (15 or 30 mg/day, n = 31) or placebo (n = 30) was randomly assigned and initiated within 5 days after the onset of ACS in 61 patients with type 2 DM and echolucent carotid plaques. Vulnerable carotid plaques were assessed by measuring plaque echolucency using carotid ultrasound with integrated backscatter (IBS) before, at 2 weeks, and 1 month and 6 months after initiation of treatment. An increase in IBS value reflects an increase in carotid plaque echogenicity. Calibrated IBS value (intima-media IBS value minus adventitia IBS value) of echolucent carotid plaques did not change at 2 weeks but was significantly increased at I month after treatment in the pioglitazone group but not in the placebo group. The increase in calibrated IBS value was not significantly correlated with the effect of pioglitazone on glycemia.Conclusions: Pioglitazone rapidly improved carotid plaque echolucency within I month of therapy initiation in patients with ACS and type 2 DM. (C) 2008 Elsevier Ireland Ltd. All rights reserved.