Pioglitazone Increases Circulating MicroRNA-24 With Decrease in Coronary Neointimal Hyperplasia in Type 2 Diabetic Patients - Optical Coherence Tomography Analysis -

초록

Background: Aberrant expression of microRNAs is associated with neointimal hyperplasia (NIH) in type 2 diabetes. We prospectively compared the effects of pioglitazone on coronary NIH and changes in microRNAs according to NIH status in type 2 diabetic patients during 9-month follow-up. Methods and Results: Type 2 diabetic patients were randomly assigned to the pioglitazone (n=36) or control groups (n=36) after coronary stenting. Primary endpoint was the comparison of changes in neointimal volume on OCT and in the level of circulating microRNA-17,-24,-92a,-126 and -145 during 9-month follow-up. Secondary endpoint was the comparison of changes in brachial artery flow-mediated dilation and inflammatory markers such as IL-6, TNF-alpha, hsCRP, adiponectin, sICAM-1, and sVCAM-1 between the 2 groups. Neointimal volume was significantly lower in the pioglitazone group (25.02 +/- 17.78 mm(3) vs. 55.10 +/- 30.01 mm(3), P<0.001) with significant increases in circulating microRNA-24 (0.264 +/- 0.084 vs. 0.006 +/- 0.030, P<0.001) during follow-up. FMD was significantly greater in the pioglitazone than control group at 9 months (0.47 +/- 0.14 mm vs. 0.28 +/- 0.18 mm, P<0.05, respectively). Decreases in inflammatory markers such as IL-6, TNF-alpha, and sVCAM-1 were significantly greater in the pioglitazone than the control group during the follow-up. Conclusions: Pioglitazone significantly decreased NIH with increases in circulating microRNA-24 at 9-month follow-up. The decrease in microRNA-24 could be used as a potential predictor of increases in NIH in type 2 diabetic patients.

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