Abstract | BACKGROUND: METHODS: RESULTS: The study cohort was composed of 3876 IRIS participants, mean age 63 years, 65% male, 89% white race, and 12% with a history of coronary artery disease. Over a median follow-up of 4.8 years, there were 225 acute coronary syndrome events, including 141 MIs and 84 episodes of unstable angina. The MIs included 28 (19%) with ST-segment elevation. The majority of MIs were type 1 (94, 65%), followed by type 2 (45, 32%). Serum troponin was 10× to 100× upper limit of normal in 49 (35%) and >100× upper limit of normal in 39 (28%). Pioglitazone reduced the risk of acute coronary syndrome (hazard ratio, 0.71; 95% confidence interval, 0.54-0.94; P=0.02). Pioglitazone also reduced the risk of type 1 MI (hazard ratio, 0.62; 95% confidence interval, 0.40-0.96; log-rank P=0.03), but not type 2 MI (hazard ratio, 1.05; 95% confidence interval, 0.58-1.91; P=0.87). Similarly, pioglitazone reduced the risk of large MIs with serum troponin >100× upper limit of normal (hazard ratio, 0.44; 95% confidence interval, 0.22-0.87; P=0.02), but not smaller MIs. CONCLUSIONS: CLINICAL TRIAL REGISTRATION: URL: http://clinicaltrials.gov. Unique identifier: NCT00091949.
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Authors | Lawrence H Young, Catherine M Viscoli, Jeptha P Curtis, Silvio E Inzucchi, Gregory G Schwartz, Anne M Lovejoy, Karen L Furie, Mark J Gorman, Robin Conwit, J Dawn Abbott, Daniel L Jacoby, Daniel M Kolansky, Steven E Pfau, Frederick S Ling, Walter N Kernan, IRIS Investigators |
Journal | Circulation
(Circulation)
Vol. 135
Issue 20
Pg. 1882-1893
(May 16 2017)
ISSN: 1524-4539 [Electronic] United States |
PMID | 28246237
(Publication Type: Controlled Clinical Trial, Journal Article, Multicenter Study)
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Copyright | © 2017 American Heart Association, Inc. |
Chemical References |
- Hypoglycemic Agents
- Thiazolidinediones
- Pioglitazone
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Topics |
- Acute Coronary Syndrome
(blood, diagnosis, drug therapy)
- Aged
- Cohort Studies
- Diabetes Mellitus, Type 2
- Double-Blind Method
- Female
- Follow-Up Studies
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Insulin Resistance
(physiology)
- Internationality
- Ischemic Attack, Transient
(blood, diagnosis, drug therapy)
- Male
- Middle Aged
- Pioglitazone
- Stroke
(blood, diagnosis, drug therapy)
- Thiazolidinediones
(therapeutic use)
- Treatment Outcome
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