CHICAGO - Using high-resolution B-mode ultrasound, researchers found that the drug pioglitazone helped prevent carotid artery wall thickening in patients with type 2 diabetes better than the comparative drug glimepiride. They presented their findings at this week's American Heart Association (AHA) meeting.
"Our results demonstrate, in a relatively large and long-term randomized trial, that pioglitazone slowed progression of carotid artery intima-media thickness compared with glimepiride," said Dr. Thomas Mazzone, a professor of medicine and pharmacology at the University of Illinois in Chicago.
The Carotid Intima-Media Thickness in Atherosclerosis Using Pioglitazone (CHICAGO) trial enrolled 462 adults with type 2 diabetes, with 232 receiving pioglitazone (Actos) and 230 receiving glimepiride (Amaryl), according to Mazzone. By the end of the 72-week study, 178 pioglitazone and 186 glimepiride patients had completed the study.
Mazzone and colleagues used high-resolution B-mode ultrasound (HD1 5000, Philips Medical Systems, Andover, MA) with a linear-array 7.5-MHz transducer to measure baseline and postbaseline carotid intima-media thickness. All scans were performed by a single sonographer at the same location using the same equipment.
Longitudinal scans of the right and left common carotid arteries were obtained to clearly visualize two parallel echogenic lines corresponding to the blood-intima and media-adventitia interfaces on the posterior artery wall. The imaging position and gain was digitally recorded using end-diastolic electrocardiographic gating.
After the ultrasound examination, masking software (Io-Mask, Synarc, Paris) was used to match follow-up scans to optimize alignment to the baseline scan. Synarc received the scans electronically and performed databasing, quality control, and prereading.
The study results showed that after the 72-week period the mean carotid intima-media thickness had declined 0.001 mm in the pioglitazone patients and had increased 0.012 mm in the glimepiride patients (p = 0.02), according to Mazzone.
The study was not powered for hard end points, he said. The only death in the study was an 80-year-old women taking pioglitazone who died of pancreatic cancer. Ten patients in the glimepiride group experienced a cardiovascular event, mainly revascularization-related events, compared with four patients on pioglitazone.
"If supported by additional research, these findings would indicate that pioglitazone can delay the progression of atherosclerosis in patients with diabetes," Mazzone said.
By Edward Susman
AuntMinnie.com contributing writer
November 13, 2006
Related Reading
Myocardial functional reserve reduced in hypertension and diabetes, September 7, 2006
Efficient insulin gene delivery by ultrasonic microbubble technology, May 16, 2006
Diabetics with no risk factors for CAD benefit from stress testing, January 11, 2006
Intensive diabetes control curbs heart risk, December 22, 2005
Coronary artery disease less common in black than white diabetics, December 21, 2005
Copyright © 2006 AuntMinnie.com
