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Cellular and Molecular Changes Associated With Inhibitory Effect of Pioglitazone on Neointimal Growth in Patients With Type 2 Diabetes After Zotarolimus-Eluting Stent Implantation

Authors
Hong, Soon JunKim, Sung TaeKim, Tae-JinKim, Eun-OkAhn, Chul-MinPark, Jae HyoungKim, Je SangLee, Kyung-MiLim, Do-Sun
Issue Date
Dec-2010
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
pioglitazone; restenosis; diabetes; inflammation; zotarolimus-eluting stent
Citation
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, v.30, no.12, pp.2655 - U602
Indexed
SCIE
SCOPUS
Journal Title
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
Volume
30
Number
12
Start Page
2655
End Page
U602
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/115269
DOI
10.1161/ATVBAHA.110.212670
ISSN
1079-5642
Abstract
Objective-To investigate the mechanistic basis underlying antirestenosis and the antiatherogenic effect of pioglitazone in patients with type 2 diabetes mellitus who were undergoing zotarolimus-eluting stent implantation. Methods and Results-Recent studies highlight the beneficial effect of pioglitazone in attenuating neointimal growth after stent implantation. Patients with coronary artery diseases were randomly assigned to pioglitazone (n = 47) or placebo (n = 47) after stent implantation. Pioglitazone significantly reduced neointimal hyperplasia within the stented lesion and attenuated total plaque burden in the in-segment regions of the stent, as assessed by intravascular ultrasonography at the 8-month follow-up. These changes were preceded by reduced circulating natural killer (NK) cells, diminished interleukin 6 and monocyte chemoattractant protein-1 levels, and downregulation of chemokine receptor 2 at 2 days after stent implantation; and an elevated interleukin 10 level at 10 days after implantation. Furthermore, the proliferation and migration of vascular smooth muscle cells were inhibited in the presence of pioglitazone-treated patient serum, demonstrating that the antiproliferative effects of pioglitazone occurred concurrently with its antiinflammatory action. Conclusion-Our data present early cellular and immunologic changes by pioglitazone that might have been associated with antirestenotic and antiatherogenic effects in diabetic patients. Inhibiting proinflammatory responses while promoting antiinflammatory circuits, together with an antiproliferative action, may, in part, account for the antirestenotic effect of pioglitazone by altering vascular remodeling processes in the early phase. (Arterioscler Thromb Vasc Biol. 2010;30:2655-2665.)
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