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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 591 - 601 (11page)
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Background and Objectives Non-statin therapy plus lower intensity statin might be an alternative in patients with coronary artery disease (CAD). A recent data suggested an anti-inflammatory therapy can reduce recurrent cardiovascular events and pioglitazone is also an intriguing inflammatory-modulating agent. However, limited data exist on whether pioglitazone on top of statins further attenuates plaque inflammation. Methods Statin-naïve patients with stable CAD and carotid plaques of ≥3 mm were randomly prescribed moderate dose atorvastatin (20 mg/day), or moderate dose atorvastatin plus pioglitazone (30 mg/day) for 3 months. The primary endpoint was the change in the arterial inflammation of the carotid artery measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) during 3 months. Results Of the 41 randomized patients, 33 underwent an evaluation by fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT; 17 atorvastatin plus pioglitazone and 16 atorvastatin patients). The addition of pioglitazone significantly improved the insulin sensitivity and increased the high-density lipoprotein cholesterol after 3 months. Although a reduction in the (FDG) uptake by pioglitazone on top of atorvastatin in carotid arteries with plaque showed marginally statistical significance in the entire patient group (atorvastatin plus pioglitazone; −0.10±0.07 and atorvastatin −0.06±0.04, p=0.058), pioglitazone showed a further reduction of the fluorodeoxyglucose (FDG) uptake among patients who had a baseline FDG uptake above the median (atorvastatin plus pioglitazone; −0.14±0.04 and atorvastatin −0.03±0.03, p<0.001). Conclusions Pioglitazone demonstrated marginally significant anti-inflammatory effects in addition to moderate dose atorvastatin. This may have been due to the lack of power of the study. However, pioglitazone may have an anti-inflammatory effect in those patients with high plaque inflammation (Trial registry at ClinicalTrials.gov, NCT01341730).
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등록된 정보가 없습니다.
참고문헌 (28)
참고문헌 신청
LaRosa JC / 2005 / Intensive lipid lowering with atorvastatin in patients with stable coronary disease / N Engl J Med 352:1425~1435
Pedersen TR / 2005 / High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial / JAMA 294:2437~2445
Arnold SV / 2014 / Patterns of statin initiation, intensification, and maximization among patients hospitalized with an acute myocardial infarction / Circulation 129:1303~1309
Preiss D / 2011 / Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis / JAMA 305:2556~2564
Lloyd-Jones DM / 2016 / 2016 ACC expert consensus decision pathway on the role of non-statin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents / J Am Coll Cardiol 68:92~125
Pedersen TR / 2005 / High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial / JAMA 294:2437~2445
Arnold SV / 2014 / Patterns of statin initiation, intensification, and maximization among patients hospitalized with an acute myocardial infarction / Circulation 129:1303~1309
Preiss D / 2011 / Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis / JAMA 305:2556~2564
Lloyd-Jones DM / 2016 / 2016 ACC expert consensus decision pathway on the role of non-statin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents / J Am Coll Cardiol 68:92~125
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