Improvement of Cardiovascular Risk Markers by Pioglitazone Is Independent From Glycemic Control

Pfützner, Andreas; Marx, Nikolaus; Lübben, G.; Langenfeld, Matthias; Walcher, Daniel; Konrad, Thomas R.; Forst, Thomas

doi:10.1016/j.jacc.2005.03.041

Cited by 261 publications

(208 citation statements)

References 39 publications

Supporting

Mentioning

181

Contrasting

Unclassified

Order By: Relevance

“…Although pioglitazone was associated with reduced CV events in the PROactive study 13) , few investigations have evaluated its effects on IMT. To date, trials have been confined to 6-month studies comparing pioglitazone with sulfonylurea oral anti-diabetic agents or diet alone 22,23) , and the more extensive CHICAGO study. This randomized double-blind trial was performed over a 72-week period in patients with type 2 diabetes in the Chicago metropolitan area, and reported that pioglitazone significantly reduced carotid IMT compared with glimepiride 12) .…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Yamasaki¹,

Katakami²,

Furukado³

et al. 2010

JAT

View full text Add to dashboard Cite

Aim:No previous studies have evaluated the long-term anti-atherosclerotic effects of pioglitazone in Asian patients with type 2 diabetes. Therefore, the present study investigated the protective effects of pioglitazone on the progression of carotid intima-media thickness (IMT), an established surrogate marker of cardiovascular events in Japanese type 2 diabetic patients without a recent history of cardiovascular morbidity. Methods: This 2.5 − 4-year, randomized, open-label, blinded endpoint study was conducted in 6 centers across Japan. Patients received pioglitazone with or without other oral glucose-lowering drugs (excluding another thiazolidinedione) (n 89) or oral glucose-lowering drugs, excluding thiazolidinediones (n 97). Treatment was adjusted to achieve HbA1c 6.5%. The primary endpoints of the study were the absolute changes from the baseline to final visit in max-and mean-IMT in the average of bilateral common carotid arteries.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Yamasaki¹,

Katakami²,

Furukado³

et al. 2010

JAT

View full text Add to dashboard Cite

show abstract

“…The inconsistent results may reflect the relatively small number of patients on pioglitazone; however, previous studies suggest beneficial effects. [21][22][23][24][25][26] Its use in patients with ESRD and diabetes will be the subject of future DOPPS analyses once additional data become available.…”

Section: Discussionmentioning

confidence: 99%

Rosiglitazone Is Associated with Mortality in Chronic Hemodialysis Patients

Ramirez

Albert

Blayney

et al. 2009

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Recent studies have associated rosiglitazone, a thiazolidinedione drug, with adverse cardiovascular outcomes in the general population with diabetes. Using data from the Dialysis Outcomes and Practice Patterns Study in the United States, we examined cardiovascular hospitalization and mortality associated with prescription of rosiglitazone, compared with other oral hypoglycemic agents, among 2393 long-term hemodialysis patients who were followed for a median of 1.1 yr. We assessed mortality risk using Cox models in patient-level and dialysis facility-level analyses that used the facility proportion of patients on rosiglitazone as the predictor (instrumental variable approach) and adjusted the models for demographics, comorbid conditions, laboratory values, and achieved dialysis dosage. Compared with patients prescribed other oral hypoglycemic agents, patients prescribed rosiglitazone had significantly higher all-cause (hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.05 to 1.82) and cardiovascular (HR 1.59; 95% CI 1.14 to 2.22) mortality, and their adjusted HR for hospitalization with myocardial infarction was 3.5-fold higher (P ϭ 0.02). We did not observe similar associations in a secondary analysis evaluating pioglitazone. By the instrumental variable approach, facilities with more than the median adjusted percentage (6.2%) of patients who had diabetes and were prescribed rosiglitazone had significantly higher all-cause mortality (HR 1.36; 95% CI 1.15 to 1.62) and cardiovascular mortality (HR 1.42; 95% CI 1.07 to 1.88) than facilities with less than the median expected percentage prescribed rosiglitazone. Our practice-based findings suggest significant associations of rosiglitazone use with higher cardiovascular and all-cause mortality among hemodialysis patients with diabetes. 20: 109420: -110120: , 200920: . doi: 10.1681 Thiazolidinedione (TZD) use is increasing in patients with diabetes. For example, its reported use rose from 7.2% in 1998 to 16.2% in 2001 in a population of Medicare patients who were hospitalized for diabetes 1 ; however, concern exists that the TZD rosiglitazone may increase the risk for adverse outcomes. A meta-analysis of 42 randomized, controlled trials comparing rosiglitazone with other oral hypoglycemic agents (OHAs), insulin, or placebo in the general population suggested a significantly higher risk for myocardial infarction (MI) and a borderline increased risk for death from cardiovascular causes. 2 Another meta-analysis of four randomized, controlled clinical trials demonstrated a 42% significantly increased risk for MI and a twofold significantly increased risk for congestive heart failure (CHF). 3 Whether rosiglitazone results in adverse clinical outcomes remains uncertain, given the limitations of meta-analysis design 2 and literature demonstrating rosiglitazone's favorable influence on glycemic control. 4,5 J Am Soc Nephrol

show abstract

“…Our literature search identified 4,021 articles, of which 12 RCTs (1,050 subjects) complied with the inclusion criteria and were therefore included in the meta-analysis (Figure 1) [18][19][20][21][22][23][24][25][26][27][28][29]. Table 1 shows the characteristics of the 12 trials, and Figure 2 shows the network map.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

Effects of sulfonylurea treatment on blood plasminogen activator inhibitor-1 levels in patients with type 2 diabetes mellitus: A network meta-analysis

Ida¹,

Murata²,

Kaneko³

2018

J Diab Res Clin Met

View full text Add to dashboard Cite

Background: To compare the effects ofthree types of sulfonylureas (glibenclamide, gliclazide, and glimepiride) on blood plasminogen activator inhibitor-1 levels in patients with type2 diabetes mellitus, a network meta-analysis of randomized controlled trialswas performed. Methods: A literature search using MEDLINE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov was conducted. Randomized controlled trialsin which the effects of sulfonylureas on blood plasminogen activator inhibitor-1 levels in patients with type 2 diabetes mellitus were evaluated were includes. Outcome assessment included standardized mean differences and 95% confidence intervals. Results: Twelve randomized controlled trials (1,050 subjects) met the inclusion criteria and were included in the network meta-analysis. No significant difference was observedin blood plasminogen activator inhibitor-1 levels after using a placebo compared with those after using glibenclamide, gliclazide, and glimepiride. Blood plasminogen activator inhibitor-1levels were significantly lower after using gliclazide than after using glimepiride (standardized mean difference: -0.52; 95% confidence interval: -0.99%-0.44%). However, no significant difference was observed in blood plasminogen activator inhibitor-1 levels after using glibenclamide compared with those after using gliclazide and glime piride. Conclusions: Regarding the use of sulfonylureas for treating patients with type 2 diabetes mellitus, gliclazide may be preferable because of low blood plasminogen activator inhibitor-1 levels after its use. However, few studies have been published on the use of gliclazide, and the quality of these studies has been generally poor; thus, the results of this study should be interpreted with caution.

show abstract

Improvement of Cardiovascular Risk Markers by Pioglitazone Is Independent From Glycemic Control

Abstract: This prospective study gives evidence of an anti-inflammatory and antiatherogenic effect of pioglitazone versus glimepiride. This effect is independent from blood glucose control and may be attributed to peroxisome proliferator-activated receptor gamma activation.

Cited by 261 publications

References 39 publications

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Rosiglitazone Is Associated with Mortality in Chronic Hemodialysis Patients

Effects of sulfonylurea treatment on blood plasminogen activator inhibitor-1 levels in patients with type 2 diabetes mellitus: A network meta-analysis

Contact Info

Product

Resources

About