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Preventative Effects of Rosiglitazone on Restenosis After Coronary Stent Implantation in Patients With Type 2 Diabetes

 Chul-Woo Ahn  ;  Donghoon Choi  ;  Bong-Soo Cha  ;  Hyun-Chul Lee  ;  Sung-Kil Lim  ;  Yangsoo Jang  ;  Young-Guk Ko  ;  Sung-Hee Choi  ;  Soo-Kyung Kim 
 DIABETES CARE, Vol.27(11) : 2654-2660, 2004 
Journal Title
Issue Date
Adult ; Aged ; Coronary Angiography ; Coronary Restenosis/diagnostic imaging ; Coronary Restenosis/prevention & control* ; Coronary Stenosis/drug therapy ; Coronary Stenosis/therapy* ; Diabetes Mellitus, Type 2*/complications ; Diabetic Angiopathies/drug therapy ; Diabetic Angiopathies/etiology ; Diabetic Angiopathies/therapy ; Female ; Humans ; Hypoglycemic Agents/therapeutic use* ; Male ; Middle Aged ; Rosiglitazone ; Stents* ; Thiazolidinediones/therapeutic use* ; Treatment Outcome ; Vasodilator Agents/therapeutic use*
CAD, coronary artery disease ; hsCRP, high-sensitivity C-reactive protein ; MLD, minimal lumen diameter ; PPAR, peroxisome proliferator–activated receptor ; QCA, quantitative coronary angiography ; TZD, thiazolidinedione ; VSMC, vascular smooth muscle cell
OBJECTIVE: Despite the popularity of coronary stenting in coronary artery disease (CAD), restenosis remains a challenging clinical problem. This study evaluated the efficacy of rosiglitazone for preventing in-stent restenosis in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: We conducted a prospective, randomized, case-controlled trial involving 95 diabetic patients with CAD who were randomly assigned to either the control or rosiglitazone group (48 and 47 patients, respectively). Quantitative coronary angiography (QCA) was performed at study entry and again at 6-month follow-up. The primary end point was the restenosis rate, which was determined by QCA. RESULTS: Eighty-three patients (45 patients with 55 lesions in the control group and 38 patients with 51 lesions in the rosiglitazone group) completed follow-up angiography. Rosiglitazone treatment for 6 months reduced fasting insulin concentration. The high-sensitivity C-reactive protein concentration was significantly reduced in the rosiglitazone group compared with that in the control group (from 2.92 +/- 1.98 to 0.62 +/- 0.44 mg/l, P < 0.001 vs. from 2.01 +/- 1.33 to 1.79 +/- 1.22 mg/l, P = NS). However, the baseline and follow-up glucose and lipid concentrations were not different between two groups. The rate of in-stent restenosis was significantly reduced in the rosiglitazone group compared with the control group (for stent lesions: 17.6 vs. 38.2%, P = 0.030). The rosiglitazone group had a significantly lower degree of diameter stenosis (23.0 +/- 23.4% vs. 40.9 +/- 31.9%, P = 0.004) compared with the control group. CONCLUSIONS: We demonstrated that treatment with rosiglitazone significantly reduces in-stent restenosis in diabetic patients with CAD who underwent coronary stent implantation.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Soo Kyung(김수경)
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Lee, Hyun Chul(이현철)
Lim, Sung Kil(임승길)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Choi, Seong Hee(최성희)
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