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Implications of Rosiglitazone and Pioglitazone on Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus
Author(s) -
Irons Brian K.,
Greene Ronald Shane,
Mazzolini Timothy A.,
Edwards Krystal L.,
Sleeper Rebecca B.
Publication year - 2006
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.26.2.168
Subject(s) - pioglitazone , rosiglitazone , medicine , insulin resistance , type 2 diabetes mellitus , hyperinsulinemia , dyslipidemia , diabetes mellitus , risk factor , coronary artery disease , sitagliptin , endocrinology , glycemic , type 2 diabetes , insulin
Clinical data suggest that thiazolidinediones—specifically, rosiglitazone and pioglitazone—may improve cardiovascular risk factors through multiple mechanisms. Low insulin sensitivity has been described as an independent risk factor for coronary artery disease and cerebrovascular disease. Patients with insulin resistance often have several known risk factors, such as obesity, dyslipidemia, and hypertension. Other emerging risk factors may be prevalent in patients with insulin resistance, such as hyperinsulinemia, elevated C‐reactive protein, elevated plasminogen activator inhibitor levels, and small, dense, low‐density lipoproteins. The only available drug class that primarily targets insulin resistance is the thiazolidinediones. These drugs have shown efficacy in affecting surrogate markers of cardiovascular risk in patients with diabetes mellitus. Alterations in these risk factors are likely due to their effects on improving insulin sensitivity and/or glycemic control. Trials to assess whether thiazolidinediones actually reduce cardiovascular outcomes are continuing.