Pioglitazone inhibits platelet function and potentiates the effects of aspirin: A prospective observation study

Mongan, John P.; Mieszczanska, Hanna Z.; Smith, Brian H.; Messing, Susan; Phipps, Richard P.; Francis, Charles W.

doi:10.1016/j.thromres.2011.12.019

Cited by 11 publications

(5 citation statements)

References 32 publications

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“…Pioglitazone may also have acted to reduce type 1 MI by retarding the progression of atherosclerosis, 7 reducing the necrotic core of plaques, 9, 10 or exerting anti-thrombotic effects. 31 In contrast, pioglitazone did not appear to prevent type 2 MIs, which were characterized by lower levels of troponin elevation. This category of MI is usually attributed to hemodynamic or metabolic stress (e.g.…”

Section: Discussionmentioning

confidence: 97%

Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack

et al. 2017

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Background Insulin resistance is highly prevalent among patients with atherosclerosis and is associated with an increased risk for myocardial infarction (MI) and stroke. The Insulin Resistance Intervention after Stroke (IRIS) trial demonstrated that pioglitazone decreased the composite risk for fatal or non-fatal stroke and MI in patients with insulin resistance without diabetes, after a recent ischemic stroke or transient ischemic attack. The type and severity of cardiac events in this population, and the impact of pioglitazone on these events has not been described. Methods We performed a secondary analysis of the effects of pioglitazone, compared to placebo, on acute coronary syndromes (ACS) (MI and unstable angina) among IRIS participants. All potential ACS episodes were adjudicated in a blinded fashion by an independent clinical events committee. Results The study cohort was composed of 3876 IRIS participants, mean age 63 years, 65% male, 89% white race, and 12% with a history of coronary artery disease. Over a median follow-up of 4.8 years, there were 225 ACS events, including 141 MI's and 84 episodes of unstable angina. The MI's included 28 (19%) with ST-segment elevation. The majority of MI's were type 1 (94, 65%), followed by type 2 (45, 32%). Serum troponin was 10× to 100× upper limit of normal (ULN) in 49 (35%) and >100× ULN in 39 (28%). Pioglitazone reduced the risk of ACS (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.54, 0.94; p=0.02). Pioglitazone also reduced the risk of type 1 MI (HR 0.62, 95% CI, 0.40, 0.96; log-rank p=0.03) but not type 2 MI (HR 1.05, 95% CI 0.58, 1.91; p=0.87). Similarly, pioglitazone reduced the risk of large MI's with serum troponin >100× ULN (HR 0.44, 95% CI, 0.22, 0.87; p=0.02), but not smaller MI's. Conclusions Among patients with insulin resistance without diabetes, pioglitazone reduced the risk for acute coronary syndromes after a recent cerebrovascular event. Pioglitazone appeared to have its most prominent effect in preventing spontaneous type 1 MI's.

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Section: Discussionmentioning

confidence: 97%

Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack

et al. 2017

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“…Conversely, sulphonylureas are associated with reduced clopidogrel efficacy in inhibiting platelet aggregation measured using light transmittance aggregometry [184]. Moreover, the concomitant use of aspirin with sulphonylureas seems to potentiate the antiplatelet effect of the former and the hypoglycaemic effect of the latter [185,186]. Finally, clopidogrel enhances the effect of pioglitazone, inhibiting its CYP2C8-mediated biotransformation [187].…”

Section: Relevant Drug Interactions Of Novel Antidiabetic Agents With...mentioning

confidence: 99%

Glycaemic Control in Patients Undergoing Percutaneous Coronary Intervention: What Is the Role for the Novel Antidiabetic Agents? A Comprehensive Review of Basic Science and Clinical Data

Nusca

Piccirillo

Bernardini

et al. 2022

IJMS

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Coronary artery disease (CAD) remains one of the most important causes of morbidity and mortality worldwide, and revascularization through percutaneous coronary interventions (PCI) significantly improves survival. In this setting, poor glycaemic control, regardless of diabetes, has been associated with increased incidence of peri-procedural and long-term complications and worse prognosis. Novel antidiabetic agents have represented a paradigm shift in managing patients with diabetes and cardiovascular diseases. However, limited data are reported so far in patients undergoing coronary stenting. This review intends to provide an overview of the biological mechanisms underlying hyperglycaemia-induced vascular damage and the contrasting actions of new antidiabetic drugs. We summarize existing evidence on the effects of these drugs in the setting of PCI, addressing pre-clinical and clinical studies and drug-drug interactions with antiplatelet agents, thus highlighting new opportunities for optimal long-term management of these patients.

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“…Another important aspect to discuss is that most RA patients take nonsteroidal anti-inflammatory drugs regularly, which can be a problem, as PRP may not achieve its therapeutic potential because platelet function and aggregation are impaired in these cases [ 37 ]. These effects may also occur with other drugs, such as pioglitazone [ 38 ].…”

Section: Reviewmentioning

confidence: 99%

The Effects of Intra-Articular Platelet-Rich Plasma Injections in Rheumatoid Arthritis: A Narrative Review

Moeda¹,

Melo²,

Hatia³

et al. 2022

Cureus

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Platelet-rich plasma injections have been a therapeutic option with exponential growth in several pathologies in the last decades, particularly musculoskeletal for their effect on improving pain and functionality. Rheumatoid arthritis is a chronic joint disease, which involves inflammation of the synovial membrane with cartilage and juxta-articular bone destruction. Conventional and biological diseasemodifying anti-rheumatoid drugs are the cornerstone of the treatment of this disease. However, the use of intra-articular glucocorticoids is often necessary and the role of platelet-rich plasma injections in these patients remains uncertain.A literature review was carried out through the PubMed database, Cochrane and Google Scholar for the search terms "rheumatoid arthritis" and "platelet-rich plasma". Eleven studies have been included in this review: two of these are in vitro studies, five are animal studies, one case report, two case series and one randomized controlled trial. Most of the studies demonstrated a decrease in pain and inflammatory mediators and improvement of functional outcomes, with no severe adverse effects reported.However, the quantity and quality of literature about the effects and safety of plasma-rich plasma injections in rheumatoid arthritis patients are still scarce. It is essential that well-designed randomized controlled trials are made on this topic to understand if platelet-rich plasma may be useful as a coadjuvant therapy in rheumatoid arthritis.

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Pioglitazone inhibits platelet function and potentiates the effects of aspirin: A prospective observation study

Cited by 11 publications

References 32 publications

Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack

Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack

Glycaemic Control in Patients Undergoing Percutaneous Coronary Intervention: What Is the Role for the Novel Antidiabetic Agents? A Comprehensive Review of Basic Science and Clinical Data

The Effects of Intra-Articular Platelet-Rich Plasma Injections in Rheumatoid Arthritis: A Narrative Review

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