Why the study?
Does thiazolidinedione therapy reduce target vessel revascularization in diabetic patients undergoing percutaneous coronary intervention?
Does thiazolidinedione therapy reduce target vessel revascularization in diabetic patients undergoing percutaneous coronary intervention?
In diabetic patients undergoing PCI, thiazolidinedione therapy did not reduce, and was actually associated with a higher rate of, target vessel revascularization at 1 year compared to other hypoglycemic regimens.
TZD therapy was associated with higher TVR after PCI in diabetics; leaves open whether this reflects confounding or a causal effect.
BACKGROUND: Animal studies have suggested that thiazolidinediones (TZDs) have antirestenotic properties. However, human data are lacking. The goal of this single-center study was to assess the target vessel revascularization (TVR) rate following percutaneous coronary intervention (PCI) among diabetic patients according to TZD use. METHODS: A total of 325 consecutive diabetic patients who underwent PCI between January 2000 and December 2001 were included in the analysis. Among them, 82 patients were on TZD and 243 patients were on other hypoglycemic regimens. All patients were treated with stents and platelet glycoprotein IIb/IIIa inhibitors at the time of intervention. TVR and death/myocardial infarction/TVR were assessed at 1 year. RESULTS: TZD patients were more likely to be younger, male and have hyperlipidemia. TVR occurred in 36.6% of TZD patients compared with 23.9% of non-TZD patients (p=0.04). One-year death, myocardial infarction and TVR occurred in 41.1% of TZD patients compared with 30.8% of non-TZD patients (p=0.04). CONCLUSION: In this retrospective analysis, TZD therapy did not decrease the need for repeat revascularization following PCI. Prospective randomized studies are warranted.
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Cho et al. (2005) studied this question.
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