Peroxisome proliferator-activated receptor γ agonists for the Prevention of Adverse events following percutaneous coronary Revascularization-results of the PPAR Study

Deepak L. Bhatt, Derek P. Chew, Cindy Grines, Debabrata Mukherjee, Massoud Leesar, Ian Gilchrist, John C. Corbelli, James C. Blankenship, Avichai Eres, Steven Steinhubl, Walter A. Tan, Jon R. Resar, Amjad AlMahameed, Ahmed Abdel-Latif, H. Wilson Tang, Danielle Brennan, Ellen McErlean, Stanley L. Hazen, Eric J. Topol

Research output: Contribution to journalArticle

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Abstract

Background: Patients with metabolic syndrome are at increased risk for cardiovascular complications. We sought to determine whether peroxisome proliferator-activated receptor gamma agonists had any beneficial effect on patients with metabolic syndrome undergoing percutaneous coronary intervention (PCI). Methods: A total of 200 patients with metabolic syndrome undergoing PCI were randomized to rosiglitazone or placebo and followed for 1 year. Carotid intima-medial thickness (CIMT), inflammatory markers, lipid levels, brain natriuretic peptide, and clinical events were measured at baseline, 6 months, and 12 months. Results: There was no significant difference in CIMT between the 2 groups. There was no difference in the 12-month composite end point of death, myocardial infarction (MI), stroke, or any recurrent ischemia (31.4% vs 30.2%, P = .99). The rate of death, MI, or stroke at 12 months was numerically lower in the rosiglitazone group (11.9% vs 6.4%, P = .19). There was a trend toward a greater decrease over time in high-sensitivity C-reactive protein values compared with baseline in the group randomized to rosiglitazone versus placebo both at 6 months (-35.4% vs -15.8%, P = .059) and 12 months (-40.0% vs -20.9%, P = .089) and higher change in high-density lipoprotein (+15.5% vs +4.1%, P = .05) and lower triglycerides (-13.9% vs +14.9%, P = .004) in the rosiglitazone arm. There was a trend toward less new onset diabetes in the rosiglitazone group (0% vs 3.3%, P = .081) and no episodes of symptomatic hypoglycemia. There was no excess of new onset of clinical heart failure in the rosiglitazone group, nor was there a significant change in brain natriuretic peptide levels. Conclusions: Patients with metabolic syndrome presenting for PCI are at increased risk for subsequent cardiovascular events. Rosiglitazone for 12 months did not appear to affect CIMT in this population, although it did have beneficial effects on high-sensitivity C-reactive protein, high-density lipoprotein, and triglycerides. Further study of peroxisome proliferator-activated receptor agonism in patients with metabolic syndrome undergoing PCI may be warranted.

Original languageEnglish (US)
Pages (from-to)137-143
Number of pages7
JournalAmerican Heart Journal
Volume154
Issue number1
DOIs
StatePublished - Jan 1 2007

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rosiglitazone
Peroxisome Proliferator-Activated Receptors
Percutaneous Coronary Intervention
Brain Natriuretic Peptide
HDL Lipoproteins
C-Reactive Protein
Stroke
Myocardial Infarction
Placebos
PPAR gamma
Hypoglycemia
Triglycerides

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Bhatt, Deepak L. ; Chew, Derek P. ; Grines, Cindy ; Mukherjee, Debabrata ; Leesar, Massoud ; Gilchrist, Ian ; Corbelli, John C. ; Blankenship, James C. ; Eres, Avichai ; Steinhubl, Steven ; Tan, Walter A. ; Resar, Jon R. ; AlMahameed, Amjad ; Abdel-Latif, Ahmed ; Tang, H. Wilson ; Brennan, Danielle ; McErlean, Ellen ; Hazen, Stanley L. ; Topol, Eric J. / Peroxisome proliferator-activated receptor γ agonists for the Prevention of Adverse events following percutaneous coronary Revascularization-results of the PPAR Study. In: American Heart Journal. 2007 ; Vol. 154, No. 1. pp. 137-143.
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abstract = "Background: Patients with metabolic syndrome are at increased risk for cardiovascular complications. We sought to determine whether peroxisome proliferator-activated receptor gamma agonists had any beneficial effect on patients with metabolic syndrome undergoing percutaneous coronary intervention (PCI). Methods: A total of 200 patients with metabolic syndrome undergoing PCI were randomized to rosiglitazone or placebo and followed for 1 year. Carotid intima-medial thickness (CIMT), inflammatory markers, lipid levels, brain natriuretic peptide, and clinical events were measured at baseline, 6 months, and 12 months. Results: There was no significant difference in CIMT between the 2 groups. There was no difference in the 12-month composite end point of death, myocardial infarction (MI), stroke, or any recurrent ischemia (31.4{\%} vs 30.2{\%}, P = .99). The rate of death, MI, or stroke at 12 months was numerically lower in the rosiglitazone group (11.9{\%} vs 6.4{\%}, P = .19). There was a trend toward a greater decrease over time in high-sensitivity C-reactive protein values compared with baseline in the group randomized to rosiglitazone versus placebo both at 6 months (-35.4{\%} vs -15.8{\%}, P = .059) and 12 months (-40.0{\%} vs -20.9{\%}, P = .089) and higher change in high-density lipoprotein (+15.5{\%} vs +4.1{\%}, P = .05) and lower triglycerides (-13.9{\%} vs +14.9{\%}, P = .004) in the rosiglitazone arm. There was a trend toward less new onset diabetes in the rosiglitazone group (0{\%} vs 3.3{\%}, P = .081) and no episodes of symptomatic hypoglycemia. There was no excess of new onset of clinical heart failure in the rosiglitazone group, nor was there a significant change in brain natriuretic peptide levels. Conclusions: Patients with metabolic syndrome presenting for PCI are at increased risk for subsequent cardiovascular events. Rosiglitazone for 12 months did not appear to affect CIMT in this population, although it did have beneficial effects on high-sensitivity C-reactive protein, high-density lipoprotein, and triglycerides. Further study of peroxisome proliferator-activated receptor agonism in patients with metabolic syndrome undergoing PCI may be warranted.",
author = "Bhatt, {Deepak L.} and Chew, {Derek P.} and Cindy Grines and Debabrata Mukherjee and Massoud Leesar and Ian Gilchrist and Corbelli, {John C.} and Blankenship, {James C.} and Avichai Eres and Steven Steinhubl and Tan, {Walter A.} and Resar, {Jon R.} and Amjad AlMahameed and Ahmed Abdel-Latif and Tang, {H. Wilson} and Danielle Brennan and Ellen McErlean and Hazen, {Stanley L.} and Topol, {Eric J.}",
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Bhatt, DL, Chew, DP, Grines, C, Mukherjee, D, Leesar, M, Gilchrist, I, Corbelli, JC, Blankenship, JC, Eres, A, Steinhubl, S, Tan, WA, Resar, JR, AlMahameed, A, Abdel-Latif, A, Tang, HW, Brennan, D, McErlean, E, Hazen, SL & Topol, EJ 2007, 'Peroxisome proliferator-activated receptor γ agonists for the Prevention of Adverse events following percutaneous coronary Revascularization-results of the PPAR Study', American Heart Journal, vol. 154, no. 1, pp. 137-143. https://doi.org/10.1016/j.ahj.2007.03.029

Peroxisome proliferator-activated receptor γ agonists for the Prevention of Adverse events following percutaneous coronary Revascularization-results of the PPAR Study. / Bhatt, Deepak L.; Chew, Derek P.; Grines, Cindy; Mukherjee, Debabrata; Leesar, Massoud; Gilchrist, Ian; Corbelli, John C.; Blankenship, James C.; Eres, Avichai; Steinhubl, Steven; Tan, Walter A.; Resar, Jon R.; AlMahameed, Amjad; Abdel-Latif, Ahmed; Tang, H. Wilson; Brennan, Danielle; McErlean, Ellen; Hazen, Stanley L.; Topol, Eric J.

In: American Heart Journal, Vol. 154, No. 1, 01.01.2007, p. 137-143.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Peroxisome proliferator-activated receptor γ agonists for the Prevention of Adverse events following percutaneous coronary Revascularization-results of the PPAR Study

AU - Bhatt, Deepak L.

AU - Chew, Derek P.

AU - Grines, Cindy

AU - Mukherjee, Debabrata

AU - Leesar, Massoud

AU - Gilchrist, Ian

AU - Corbelli, John C.

AU - Blankenship, James C.

AU - Eres, Avichai

AU - Steinhubl, Steven

AU - Tan, Walter A.

AU - Resar, Jon R.

AU - AlMahameed, Amjad

AU - Abdel-Latif, Ahmed

AU - Tang, H. Wilson

AU - Brennan, Danielle

AU - McErlean, Ellen

AU - Hazen, Stanley L.

AU - Topol, Eric J.

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Background: Patients with metabolic syndrome are at increased risk for cardiovascular complications. We sought to determine whether peroxisome proliferator-activated receptor gamma agonists had any beneficial effect on patients with metabolic syndrome undergoing percutaneous coronary intervention (PCI). Methods: A total of 200 patients with metabolic syndrome undergoing PCI were randomized to rosiglitazone or placebo and followed for 1 year. Carotid intima-medial thickness (CIMT), inflammatory markers, lipid levels, brain natriuretic peptide, and clinical events were measured at baseline, 6 months, and 12 months. Results: There was no significant difference in CIMT between the 2 groups. There was no difference in the 12-month composite end point of death, myocardial infarction (MI), stroke, or any recurrent ischemia (31.4% vs 30.2%, P = .99). The rate of death, MI, or stroke at 12 months was numerically lower in the rosiglitazone group (11.9% vs 6.4%, P = .19). There was a trend toward a greater decrease over time in high-sensitivity C-reactive protein values compared with baseline in the group randomized to rosiglitazone versus placebo both at 6 months (-35.4% vs -15.8%, P = .059) and 12 months (-40.0% vs -20.9%, P = .089) and higher change in high-density lipoprotein (+15.5% vs +4.1%, P = .05) and lower triglycerides (-13.9% vs +14.9%, P = .004) in the rosiglitazone arm. There was a trend toward less new onset diabetes in the rosiglitazone group (0% vs 3.3%, P = .081) and no episodes of symptomatic hypoglycemia. There was no excess of new onset of clinical heart failure in the rosiglitazone group, nor was there a significant change in brain natriuretic peptide levels. Conclusions: Patients with metabolic syndrome presenting for PCI are at increased risk for subsequent cardiovascular events. Rosiglitazone for 12 months did not appear to affect CIMT in this population, although it did have beneficial effects on high-sensitivity C-reactive protein, high-density lipoprotein, and triglycerides. Further study of peroxisome proliferator-activated receptor agonism in patients with metabolic syndrome undergoing PCI may be warranted.

AB - Background: Patients with metabolic syndrome are at increased risk for cardiovascular complications. We sought to determine whether peroxisome proliferator-activated receptor gamma agonists had any beneficial effect on patients with metabolic syndrome undergoing percutaneous coronary intervention (PCI). Methods: A total of 200 patients with metabolic syndrome undergoing PCI were randomized to rosiglitazone or placebo and followed for 1 year. Carotid intima-medial thickness (CIMT), inflammatory markers, lipid levels, brain natriuretic peptide, and clinical events were measured at baseline, 6 months, and 12 months. Results: There was no significant difference in CIMT between the 2 groups. There was no difference in the 12-month composite end point of death, myocardial infarction (MI), stroke, or any recurrent ischemia (31.4% vs 30.2%, P = .99). The rate of death, MI, or stroke at 12 months was numerically lower in the rosiglitazone group (11.9% vs 6.4%, P = .19). There was a trend toward a greater decrease over time in high-sensitivity C-reactive protein values compared with baseline in the group randomized to rosiglitazone versus placebo both at 6 months (-35.4% vs -15.8%, P = .059) and 12 months (-40.0% vs -20.9%, P = .089) and higher change in high-density lipoprotein (+15.5% vs +4.1%, P = .05) and lower triglycerides (-13.9% vs +14.9%, P = .004) in the rosiglitazone arm. There was a trend toward less new onset diabetes in the rosiglitazone group (0% vs 3.3%, P = .081) and no episodes of symptomatic hypoglycemia. There was no excess of new onset of clinical heart failure in the rosiglitazone group, nor was there a significant change in brain natriuretic peptide levels. Conclusions: Patients with metabolic syndrome presenting for PCI are at increased risk for subsequent cardiovascular events. Rosiglitazone for 12 months did not appear to affect CIMT in this population, although it did have beneficial effects on high-sensitivity C-reactive protein, high-density lipoprotein, and triglycerides. Further study of peroxisome proliferator-activated receptor agonism in patients with metabolic syndrome undergoing PCI may be warranted.

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