Key result
Thiazolidinediones significantly reduced plaque volume (SMD -0.46) and increased adiponectin levels compared to control in diabetic patients with coronary atherosclerosis.
Why the study?
Although thiazolidinediones exhibit anti-inflammatory and antioxidant properties that may inhibit coronary atherosclerosis, evidence-based data suggest they may increase cardiovascular adverse event risks.
Do thiazolidinediones improve vascular endothelial and plaque-related indicators in diabetic patients with coronary atherosclerosis?
Meta-Analysis (n=451)
Do thiazolidinediones improve vascular endothelial and plaque-related indicators in diabetic patients with coronary atherosclerosis?
Standardized Mean Difference: -0.46 (95% CI -0.67–-0.24)
p-value: p=<0.0001
Thiazolidinediones may inhibit plaque progression and protect the vascular endothelium in diabetic patients with coronary atherosclerosis, independent of inflammation and lipid metabolism regulation.
Supports thiazolidinedione consideration for plaque attenuation in diabetic CAD; extends meta-analytic evidence on vascular benefits.
Rosiglitazone (Avandia) and pioglitazone (Actos) belong to the class of thiazolidinediones (TZDs) drugs that act by increasing insulin sensitivity and are widely used for treating diabetic patients with insulin resistance. TZDs exhibit anti-inflammatory and antioxidant properties, then may play an active role in inhibiting plaque formation and coronary atherosclerosis. But the results of evidence-based medicine suggest that TZDs may increase the risk of cardiovascular adverse events. To explore the dispute in depth, our meta-analysis aimed to evaluate the changes in vascular endothelial and plaque-related indicators following treatment with TZDs in diabetic patients with coronary atherosclerosis. According to our meta-analysis, TZDs showed an inhibiting effect on plaque progression and a protective effect on the vascular endothelium in patients with diabetes and coronary atherosclerosis. Interestingly, these effects may not depend on the regulation of inflammation and lipid metabolism. By this token, TZDs may develop a potential protective effect on myocardial infarction. Systematic review registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021231663].
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Xue et al. (2022) conducted a meta-analysis in Type 2 diabetes with coronary atherosclerosis (n=451). Thiazolidinediones (rosiglitazone or pioglitazone) vs. Placebo or basic treatment was evaluated on Plaque volume (SMD -0.46, 95% CI -0.67, -0.24, p=<0.0001). Thiazolidinediones significantly reduced plaque volume (SMD -0.46) and increased adiponectin levels compared to control in diabetic patients with coronary atherosclerosis.
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