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Effects of pioglitazone on fasting and postprandial levels of lipid and hemostatic variables in overweight non‐diabetic patients with coronary artery disease
Author(s) -
MIESZCZANSKA H.,
KABA N. K.,
FRANCIS C. W.,
GERICH J. E.,
DODIS R.,
SCHWARZ K. Q.,
PHIPPS R. P.,
SMITH B. H.,
LEE M.,
MESSING S.,
TAUBMAN M. B.
Publication year - 2007
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2007.02442.x
Subject(s) - postprandial , pioglitazone , medicine , lipid profile , endocrinology , coronary artery disease , overweight , diabetes mellitus , insulin , placebo , type 2 diabetes , gastroenterology , obesity , alternative medicine , pathology
Summary. Objectives: To evaluate the effects of pioglitazone on insulin sensitivity and levels of biomarkers associated with thrombotic risk in overweight and obese, non‐diabetic subjects with coronary artery disease. Background: Little information is available regarding the effects of thiazolidinediones in the absence of diabetes. Further, although postprandial hyperlipemia is a risk factor for cardiovascular diseases, there is limited information about the postprandial effects. Methods: Twenty overweight and obese, non‐diabetic patients with coronary artery disease were enrolled in a randomized, placebo‐controlled, double‐blind study. Subjects were on atorvastatin for the duration of the study and received either placebo or pioglitazone (45 mg day −1 ) for 12 weeks and then crossed over to the alternative therapy for an additional 12 weeks. Insulin sensitivity, fasting and postprandial levels of lipid, hemostatic, and inflammatory variables were measured, and endothelial function was assessed. Results: Insulin sensitivity improved from 0.03 μmol kg −1 ·min p m −1 on placebo to 0.04 on pioglitazone ( P = 0.0002), and there were decreases in fasting levels of factor (F) VII:C (102 ± 17% to 92 ± 18%, P = 0.001), FVII:Ag (68 ± 12% to 60 ± 14%, P = 0.01) and in von Willebrand factor (VWF) (174 ± 94% to 142 ± 69%, P = 0.01). Pioglitazone lowered postprandial levels of FVII:Ag, FVII:C, plasminogen activator inhibitor‐1, VWF, and triglycerides, and increased high‐density lipoproteins (+9%, P = 0.02). Conclusions: Pioglitazone improves insulin sensitivity and favorably modifies fasting and postprandial lipid, hemostatic and inflammatory markers of the metabolic syndrome in overweight and obese non‐diabetic patients with coronary artery disease.