1048 Randomized controlled trial of the effect of rosiglitazone on carotid atherosclerosis in diabetic patients
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BioMed Central
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Meeting abstract
1048 Randomized controlled trial of the effect of rosiglitazone on carotid atherosclerosis in diabetic patients Anitha Varghese*1, Des Johnson2 and Dudley J Pennell1 Address: 1CMR Unit, Royal Brompton Hospital, London, UK and 2Diabetic Medicine and Endocrinology, St Mary's Hospital, London, UK * Corresponding author
from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A173
doi:10.1186/1532-429X-10-S1-A173
Abstracts of the 11th Annual SCMR Scientific Sessions - 2008
Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdfThis abstract is available from: http://jcmr-online.com/content/10/S1/A173 © 2008 Varghese et al; licensee BioMed Central Ltd.
Introduction There has been much interest in carotid artery wall thickening as a marker of atherosclerosis, both by ultrasound and more recently by magnetic resonance (MR). Ultrasound measurements are limited by the presumption that the vessel is uniform. MR does not have this limitation. Rosiglitazone (RSG) is a nuclear PPAR-gamma agonist and has important effects in diabetes control which has led to its widespread use as a complement to existing diabetes drugs. It is known to lead to minor fluid retention in some patients, and recent reports suggest that it may be associated with an increased risk of ischemic cardiovascular events. However, this effect is controversial and may not be seen with all glitazones.
3D stack of high-resolution fast spin echo images centred on the carotid bifurcation. Maximal coverage was 56 mm (28 mm either side of the bifurcation) with a slice thickness of 2 mm. Where possible, bilateral carotid evaluation was undertaken. Using dedicated semi-automated software (Atheroma Tools, Cardiovascular Imaging Solutions, London) we traced the internal and external carotid artery surfaces for each slice and hence measured the luminal area and the wall area. Using the 3D model of the carotid artery generated by this analysis, we measured the lumen volume and total vessel volume to generate a total wall volume, a measure of atherosclerotic burden. Data was analysed using analysis of covariance.
Results Purpose We conducted a CMR study of the use of rosiglitazone in diabetic patients to determine its effect on atherosclerotic burden.
There was no significant difference in carotid atheroma between subjects treated with Rosiglitazone or placebo after 1 year. (Table 1).
Conclusion Methods We enrolled 48 patients with type 2 diabetes mellitus. There were 41 male and 7 female subjects, 80% were talking statins/fibrates. Subjects were eligible if they had documented carotid atheroma on screening carotid ultrasonography and then underwent carotid CMR at baseline, six months, and after 1 year. Patients were randomised to RSG 4 mg od (uptitrated to RSG 4 mg bd at 12 wks) or placebo i
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