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AHA: Pioglitazone Best for Slowing Artery Wall Expansion

Slower carotid intima-media thickness changes seen with pioglitazone

MONDAY, Nov. 13 (HealthDay News) -- Pioglitazone slows the progression of carotid artery wall thickness in patients with type 2 diabetes mellitus better than glimepiride, according to a report published online Nov. 13 in the Journal of the American Medical Association. The findings were presented at the American Heart Association's Scientific Sessions in Chicago.

Theodore Mazzone, M.D., of the University of Illinois College of Medicine in Chicago, and colleagues conducted a randomized, double-blind, controlled multicenter trial to compare the effects of pioglitazone versus glimepiride on changes in common carotid artery intima-media thickness (CIMT) in 462 adult patients with type 2 diabetes mellitus.

The investigators found that at 24, 48 and 72 weeks of treatment, pioglitazone produced a smaller change in CIMT in the left and right common carotid arteries, and slowed progression of maximum CIMT compared with glimepiride. The effect was apparent across multiple subgroups including those based on age, sex, blood pressure and body mass index.

"We found that, compared with glimepiride, pioglitazone reduced CIMT progression, a validated surrogate end point for coronary artery disease and cardiovascular risk," the authors conclude. While this study was conducted with individuals having good blood pressure, low LDL-cholesterol levels and regular statin use, additional studies are needed to determine whether routine use of pioglitazone instead of glimepiride substantially reduces major cardiovascular events.

The authors report multiple financial disclosures.

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