Cardioprotective effects of thiazolidinediones, peroxisome proliferator-activated receptor-gamma agonists.

Greater myocardial injury in response to ischemia/ reperfusion (I/R) and increased incidence of congestive heart failure and death in noninsulin-dependent diabetes mellitus, or type 2 diabetes, patients has been clearly identified. Thiazolidinediones (TZDs), peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonists, act as insulin sensitizers and are a novel class of oral antidiabetic drugs. An emerging body of evidence, mainly from preclinical studies, suggest that TZDs protect the heart from acute I/R injury and also might attenuate cardiac remodeling and heart failure. The mechanisms involved in this cardioprotection by TZDs are multi-factorial and not completely understood. These novel activities of TZDs could benefit type 2 diabetes patients and offer benefits beyond glycemic control. This new knowledge about the cardioprotective effects of TZDs is still limited, and more investigations, especially clinical studies, are required.