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Drug Inhibits Restenosis in Diabetics After Stent

Group receiving pioglitazone after bare-metal stent placement had lower restenosis rate

THURSDAY, June 18 (HealthDay News) -- The drug pioglitazone can help prevent restenosis after the placement of a bare-metal stent in a patient with type 2 diabetes mellitus, according to a study in the June Journal of the American College of Cardiology: Cardiovascular Interventions.

Tsutomu Takagi, M.D., of the Takagi Cardiology Clinic in Kyoto, Japan, and colleagues recruited 97 patients with diabetes who were to undergo percutaneous coronary intervention to place a bare-metal stent. Following the procedure, 48 patients were randomized to take 30 mg/d of the peroxisome proliferator-activated receptor gamma agonist, pioglitazone, while 49 patients served as a control group without pioglitazone. Angiographical and intravascular ultrasound images were obtained at baseline and six months after the procedure for comparison. The primary study end points were restenosis determined by angiography and target lesion revascularization at six months. A secondary study end point was in-stent neointimal volume determined by intravascular ultrasound.

The researchers found that the rate of restenosis was 17 percent in the pioglitazone group compared to 35 percent in the control group. Target lesion revascularization was 12.5 percent in the pioglitazone group compared to 29.8 percent in the control group. At six months follow-up, in-stent neointimal volume was smaller in the pioglitazone group than in the control group.

"Pioglitazone suppresses in-stent neointimal proliferation and therefore reduces angiographical and clinical restenosis six months after percutaneous coronary intervention in patients with type 2 diabetes mellitus. The additive impact of pioglitazone on restenosis and target lesion revascularization as well as stent thrombosis after placement of drug-eluting stent needs further investigations," the authors write.

Authors of an accompanying editorial reported relationships with several pharmaceutical companies.

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