Clinical InvestigationInterventional CardiologyPeroxisome proliferator–activated receptor γ agonists for the Prevention of Adverse events following percutaneous coronary Revascularization—results of the PPAR Study
Section snippets
Methods
PPAR was a randomized, multicenter, double-blind, two-arm pilot study comparing the effects of rosiglitazone maleate (4 mg BID orally) before and after PCI in patients with obesity and hypertension, dyslipidemia, or glucose intolerance when compared to placebo. Between January 2002 and August 2003, a total of 200 patients from 10 centers were randomized from the population of patients undergoing diagnostic angiography followed by PCI and in those in whom coronary anatomy was known and PCI was
Results
The baseline demographics of the placebo and rosiglitazone groups are listed in Table I, and the procedural characteristics are listed in Table II. Concomitant baseline medications are listed in Table III. Of note, there was a very high usage of lipid-lowering therapy.
There was no significant difference in CIMT progression rates or maximum/mean CIMT at 6 or 12 months in the rosiglitazone group compared with the placebo group, although 85 patients did not have evaluable data (Table IV). There
Discussion
This study has found a high rate of cardiovascular complications in patients with metabolic syndrome who present for PCI. The cumulative rate of death, MI, stroke, rehospitalization for recurrent ischemia or repeat target vessel revascularization was over 30% by 1-year follow-up in this population, illustrating the high-risk nature of patients with metabolic syndrome. While drug-eluting stents may be expected to reduce the rate of target vessel revascularization, other approaches will be
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Cited by (0)
This study was funded by GlaxoSmithKline.
Dr Bhatt reports having received honoraria for consulting on scientific advisory boards from Astra Zeneca, Bristol Myers Squibb, Cardax, Centocor, Daiichi-Sankyo, Eisai, Eli Lilly, GlaxoSmithKline, Millennium, Otsuka, Paringenix, PDL, Sanofi Aventis, Schering Plough, The Medicines Company, TNS Healthcare—all such honoraria are currently donated to nonprofit organizations. Dr Tang has served on the speakers' bureau for Takeda Pharmaceuticals and is a consultant to Amylin Pharmaceuticals, GlaxoSmithKline Pharmaceuticals, Philadelphia, PA, and F-Hoffman La Roche, Inc. The other authors did not report any disclosures.