Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China; Department of Cardiology, Shanghai Minhang Hospital, Fudan University, Shanghai, People's Republic of China.
Department of Cardiology, Shanghai Minhang Hospital, Fudan University, Shanghai, People's Republic of China.
Hellenic J Cardiol. 2017 Sep-Oct;58(5):387-390. doi: 10.1016/j.hjc.2017.01.025. Epub 2017 Mar 24.
Inflammation is associated with atrial fibrillation (AF), and peroxisome proliferator-activated receptor-gamma (PPARγ) agonists have anti-inflammatory properties. We tested whether pioglitazone reduced AF recurrence after electrical cardioversion (EC) by modifying systemic inflammation. In this randomized and prospective trial, patients with persistent AF and type 2 diabetes mellitus were randomized into a pioglitazone group (n=48) or a control group (n=49) before EC. Treatment was continued for 3 months or until AF recurred. Serum inflammatory markers [high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α)] were measured at baseline and follow-up. During the 3-month follow-up, AF recurred in 22 (45.8%) patients of the pioglitazone-treated and 24 (49.0%) patients of the control group (P=0.756). However, the 3 inflammatory markers were significantly lowered with pioglitazone treatment during follow-up. Cox proportional hazards regression models showed that the predictors of recurrence included AF history (relative risk RR 1.002, 95% CI 1.003-1.061, P =0.037) and the left atrial diameter (RR 1.131, 95% CI 1.029-1.242, P = 0.010). In conclusion, while reducing some inflammatory markers, the PPARγ agonist pioglitazone did not affect the recurrence of AF after EC.
炎症与心房颤动（AF）有关，过氧化物酶体增殖物激活受体-γ（PPARγ）激动剂具有抗炎作用。我们测试了吡格列酮是否通过改变全身炎症来减少电复律（EC）后的 AF 复发。在这项随机前瞻性试验中，患有持续性 AF 和 2 型糖尿病的患者在 EC 前被随机分为吡格列酮组（n=48）或对照组（n=49）。治疗持续 3 个月或直至 AF 复发。在基线和随访时测量血清炎症标志物[高敏 C 反应蛋白（hs-CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）]。在 3 个月的随访期间，吡格列酮治疗组有 22 名（45.8%）患者和对照组有 24 名（49.0%）患者发生 AF 复发（P=0.756）。然而，在随访期间，吡格列酮治疗可显著降低 3 种炎症标志物。Cox 比例风险回归模型显示，复发的预测因素包括 AF 病史（相对风险 RR 1.002，95%CI 1.003-1.061，P=0.037）和左心房直径（RR 1.131，95%CI 1.029-1.242，P=0.010）。总之，虽然 PPARγ 激动剂吡格列酮降低了一些炎症标志物，但对 EC 后 AF 的复发没有影响。
