Staniloae C, Mandadi V, Kurian D, Coppola J, Bernaski E, El-Khally Z, Morlote M, Pinassi E, Ambrose J
St. Vincent Medical Center Manhattan, New York, NY 10011, USA.
Cardiology. 2007;108(3):164-9. doi: 10.1159/000096601. Epub 2006 Oct 20.
To test the hypothesis that pioglitazone, a peroxisome proliferator-activated receptor-gamma agonist, will improve endothelial function in non-diabetic subjects with coronary artery disease, we conducted a prospective study to evaluate the effect of this medication on the brachial artery vasomotor function and circulating markers of endothelial activation.
Baseline characteristics were collected. After initial endothelial function assessment, patients were treated with pioglitazone hydrochloride 30 mg daily. The medication was continued for 12 weeks and endothelial function was reassessed as well as the inflammatory markers. The study medication then was stopped, and all the tests were repeated 12 weeks later.
Seventeen subjects completed all three-study phases. Mean age was 58 (range: 36-77 years). Compared with the baseline, the endothelium-dependent vasodilation improved significantly with the treatment (p < 0.001) from 4.4 +/- 3.9 to 8.4 +/- 4.1%, a relative increase of 91%. After withdrawal of treatment, the endothelium-dependent vasodilation returned towards baseline values. There was no change in endothelium-independent vasodilatation (12.27 +/- 6.35 to 13.9 +/- 9.23%, to 12.42 +/- 5.35%, p = 0.177). The urine asymmetric dimethlyarginine levels decreased significantly with the treatment, but also returned to the initial values after the wash-out period (1.27 +/- 0.5 micromol/ml to 0.97 +/- 0.3 micromol/ml to 1.34 +/- 0.5 micromol/ml, p = 0.017). No difference in the lipid profile, C-reactive protein, erythrocyte sedimentation rate, or fibrinogen levels was seen.
Pioglitazone rapidly improves endothelial function in non-diabetic patients with coronary artery disease. This improvement is associated with a change in mean urinary asymmetric dimethylarginine levels, although a cause and effect cannot be determined from this investigation.
为了验证过氧化物酶体增殖物激活受体γ激动剂吡格列酮能改善非糖尿病冠心病患者内皮功能这一假设，我们进行了一项前瞻性研究，以评估该药物对肱动脉血管舒缩功能及内皮激活循环标志物的影响。
收集基线特征。在初始内皮功能评估后，患者每日服用30毫克盐酸吡格列酮进行治疗。该药物持续服用12周，之后重新评估内皮功能及炎症标志物。然后停用研究药物，12周后重复所有检测。
17名受试者完成了全部三个研究阶段。平均年龄为58岁（范围：36 - 77岁）。与基线相比，治疗后内皮依赖性血管舒张功能显著改善（p < 0.001），从4.4±3.9%提高到8.4±4.1%，相对增加了91%。停药后，内皮依赖性血管舒张功能恢复至基线值。非内皮依赖性血管舒张功能无变化（从12.27±6.35%到13.9±9.23%，再到12.42±5.35%，p = 0.177）。治疗后尿不对称二甲基精氨酸水平显著降低，但在洗脱期后也恢复至初始值（从1.27±0.5微摩尔/毫升降至0.97±0.3微摩尔/毫升，再升至1.34±0.5微摩尔/毫升，p = 0.017）。血脂谱、C反应蛋白、红细胞沉降率或纤维蛋白原水平未见差异。
吡格列酮能迅速改善非糖尿病冠心病患者的内皮功能。这种改善与平均尿不对称二甲基精氨酸水平的变化有关，尽管本研究无法确定因果关系。
