Varghese Anitha, Yee Michael S, Chan Cheuk F, Crowe Lindsey A, Keenan Niall G, Johnston Desmond G, Pennell Dudley J
National Heart and Lung Institute, Imperial College, London, UK.
J Cardiovasc Magn Reson. 2009 Jul 27;11(1):24. doi: 10.1186/1532-429X-11-24.
There is recent evidence suggesting that rosiglitazone increases death from cardiovascular causes. We investigated the direct effect of this drug on atheroma using 3D carotid cardiovascular magnetic resonance.
A randomized, placebo-controlled, double-blind study was performed to evaluate the effect of rosiglitazone treatment on carotid atherosclerosis in subjects with type 2 diabetes and coexisting vascular disease or hypertension. The primary endpoint of the study was the change from baseline to 52 weeks of carotid arterial wall volume, reflecting plaque burden, as measured by carotid cardiovascular magnetic resonance. Rosiglitazone or placebo was allocated to 28 and 29 patients respectively. Patients were managed to have equivalent glycemic control over the study period, but in fact the rosiglitazone group lowered their HbA1c by 0.88% relative to placebo (P < 0.001). Most patients received a statin or fibrate as lipid control medication (rosiglitazone 78%, controls 83%). Data are presented as mean +/- SD. At baseline, the carotid arterial wall volume in the placebo group was 1146 +/- 550 mm3 and in the rosiglitazone group was 1354 +/- 532 mm3. After 52 weeks, the respective volumes were 1134 +/- 523 mm3 and 1348 +/- 531 mm3. These changes (-12.1 mm3 and -5.7 mm3 in the placebo and rosiglitazone groups, respectively) were not statistically significant between groups (P = 0.57).
Treatment with rosiglitazone over 1 year had no effect on progression of carotid atheroma in patients with type 2 diabetes mellitus compared to placebo.
最近有证据表明罗格列酮会增加心血管疾病导致的死亡风险。我们使用三维颈动脉心血管磁共振成像技术研究了该药对动脉粥样硬化的直接影响。
开展了一项随机、安慰剂对照、双盲研究，以评估罗格列酮治疗对2型糖尿病合并血管疾病或高血压患者颈动脉粥样硬化的影响。该研究的主要终点是通过颈动脉心血管磁共振成像测量的，从基线到52周时颈动脉壁体积的变化，这反映了斑块负荷。罗格列酮组和安慰剂组分别纳入了28例和29例患者。在研究期间，两组患者的血糖控制水平相当，但实际上罗格列酮组的糖化血红蛋白水平相对于安慰剂组降低了0.88%（P < 0.001）。大多数患者接受了他汀类药物或贝特类药物作为血脂控制药物（罗格列酮组78%，对照组83%）。数据以平均值±标准差表示。基线时，安慰剂组的颈动脉壁体积为1146±550 mm³，罗格列酮组为1354±532 mm³。52周后，相应体积分别为1134±523 mm³和1348±531 mm³。两组之间这些变化（安慰剂组和罗格列酮组分别为-12.1 mm³和-5.7 mm³）无统计学意义（P = 0.57）。
与安慰剂相比，罗格列酮治疗1年对2型糖尿病患者颈动脉粥样硬化的进展没有影响。
