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Endothelial dysfunction has been documented in patients with type 2 diabetes or in patients with hypertension. We prospectively investigated the effects of pioglitazone in improving endothelial function in hypertensive type 2 diabetic patients during the 6–month follow–up.
Hypertensive type 2 diabetic patients were randomly assigned to pioglitazone (n=25) or placebo (n=25). Primary endpoint was to compare changes in brachial artery flow–mediated dilation (baFMD) between the 2 groups during the 6–month follow–up. Secondary endpoints were to compare changes in the circulating levels of microRNA–17, −21, 92a, −126 and −145 which have been known as indicators of endothelial cell migration and atherosclerosis progression during the 6–month follow–up. Inflammatory markers such as IL–6, TNF–alpha, high–sensitive C–reactive protein, adiponectin, ICAM–1, and VCAM–1 were compared during the follow–up.
The rates of risk factors such as hyperlipidemia, smoking, stroke, and family history of coronary artery disease did not show significant differences between the 2 groups. Increases in baFMD (3.3 ± 3.4mm vs. 0.2 ± 2.5mm, p<0.05, respectively) and in the level of circulating microRNA–21 (0.23 ± 0.05 vs. −0.06 ± 0.04, p<0.05, respectively) were significantly greater in the pioglitazone group when compared to the placebo group during the 6–month follow–up. No occurrence of new onset heart failure, fracture, and bladder cancer was noted during the follow–up in both groups. Decreases in the levels of inflammatory marker such as IL–6 (−2.54±2.32pg/mL vs. −1.34±2.12pg/mL, p<0.05, respectively), TNF–alpha (−1.54±1.51pg/mL vs. 0.14±1.12pg/mL, p<0.05, respectively), ICAM–1 (−39±52ng/mL vs. 6±72ng/mL, p<0.05, respectively), and VCAM–1 (−154±198ng/mL vs. −11±356ng/mL, p<0.05, respectively) were significantly greater in the pioglitazone group compared to the placebo group during the follow–up.
Pioglitazone significantly increased baFMD with increases in endothelial cell microRNA–21 and decreases in inflammatory markers such as IL–6, TNF–alpha, ICAM–1 and VCAM–1 during the 6–month follow–up.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Spotlight on the Endothelium
Abstract Category: 35. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1211–172
- 2013 American College of Cardiology Foundation