PMID- 19321493
OWN - NLM
STAT- MEDLINE
DCOM- 20090707
LR  - 20181201
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 95
IP  - 13
DP  - 2009 Jul
TI  - Efficacy and safety of pioglitazone in patients with ST elevation myocardial 
      infarction treated with primary stent implantation.
PG  - 1079-84
LID - 10.1136/hrt.2008.162842 [doi]
AB  - BACKGROUND: Recent studies have shown that thiazolidinediones reduce neointimal 
      hyperplasia after bare metal stent (BMS) implantation, but this drug group 
      sometimes cause fluid retention that may lead to heart failure. OBJECTIVES: To 
      examine the safety and efficacy of pioglitazone in patients with ST elevation 
      myocardial infarction (STEMI) treated with primary BMS implantation. METHODS: 
      Diabetic or non-diabetic patients with STEMI (<12 h from onset) successfully 
      treated with primary BMS implantation were randomised to either the pioglitazone 
      (15 mg, up to 30 mg) or control groups. Patients in cardiogenic shock were 
      excluded. Primary efficacy end point was percentage neointimal volume within the 
      stented segment at 6 months using three-dimensional intravascular ultrasound. 
      Safety end point was a composite of all-cause mortality, reinfarction, or heart 
      failure requiring hospitalisation. RESULTS: Between October 2005 and July 2007, 
      96 patients were randomised into the pioglitazone (n = 48) or control group (n = 
      48). At follow-up, mean (SD) percentage neointimal volume and neointimal volume 
      index were significantly reduced in the pioglitazone group (22 (13)% vs 28 (13)%, 
      p = 0.04; 1.5 (0.9) vs 2.0 (0.8) mm(3)/mm, p = 0.02, respectively). During 6 
      months, two control patients died, four patients (one in the pioglitazone group, 
      three controls) had stent thrombosis resulting in reinfarction and three patients 
      (two in the pioglitazone group, one control) had heart failure, resulting in a 
      similar incidence of safety end point (3 vs 6). CONCLUSIONS: Treatment of 
      pioglitazone reduced neointimal hyperplasia in patients with STEMI treated with 
      primary stent implantation without placing the patient at increased risk of 
      complications. Additional larger trials will be necessary to establish the 
      clinical benefit of pioglitazone.
FAU - Kaneda, H
AU  - Kaneda H
AD  - Cardiology and Catheterisation Laboratories, Shonan Kamakura General Hospital, 
      1202-1 Yamazaki, Kamakura 247-8533, Japan. hdkaneda@gmail.com
FAU - Shiono, T
AU  - Shiono T
FAU - Miyashita, Y
AU  - Miyashita Y
FAU - Takahashi, S
AU  - Takahashi S
FAU - Taketani, Y
AU  - Taketani Y
FAU - Domae, H
AU  - Domae H
FAU - Matsumi, J
AU  - Matsumi J
FAU - Mizuno, S
AU  - Mizuno S
FAU - Minami, Y
AU  - Minami Y
FAU - Sugitatsu, K
AU  - Sugitatsu K
FAU - Saito, S
AU  - Saito S
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20090324
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Thiazolidinediones)
RN  - X4OV71U42S (Pioglitazone)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angioplasty, Balloon, Coronary
MH  - Coronary Angiography
MH  - Coronary Restenosis/diagnosis/pathology/prevention & control
MH  - Coronary Vessels/diagnostic imaging/pathology
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/prevention & control
MH  - Humans
MH  - Hyperplasia/prevention & control
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/therapy
MH  - Patient Compliance
MH  - Pioglitazone
MH  - *Stents
MH  - Thiazolidinediones/*therapeutic use
MH  - Treatment Outcome
MH  - Tunica Intima/diagnostic imaging/pathology
MH  - Ultrasonography
EDAT- 2009/03/27 09:00
MHDA- 2009/07/08 09:00
CRDT- 2009/03/27 09:00
PHST- 2009/03/27 09:00 [entrez]
PHST- 2009/03/27 09:00 [pubmed]
PHST- 2009/07/08 09:00 [medline]
AID - hrt.2008.162842 [pii]
AID - 10.1136/hrt.2008.162842 [doi]
PST - ppublish
SO  - Heart. 2009 Jul;95(13):1079-84. doi: 10.1136/hrt.2008.162842. Epub 2009 Mar 24.