To determine (1) the medium-term effect of rosiglitazone and glipizide on intra-stent neointima hyperplasia, (2) restenosis pattern as assessed by intravascular ultrasound (IVUS) and quantitative coronary angiography (QCA) in patients with T2DM and coronary artery disease. A total of 462 patients with T2DM were randomized to rosiglitazone or glipizide for up to 18 months in the APPROACH trial, and had evaluable baseline and follow-up IVUS examinations. There was no significant difference in the size of plaque behind stent between the rosiglitazone and glipizide groups at 18 months among those treated with a bare metal stent (-5.6 mm 3 vs. 1.9 mm 3; P = 0.61) or with a drug-eluting stent (12.1mm 3 vs. 5.5 mm 3; P = 0.09). Similarly, there was no significant difference in percentage intimal hyperplasia volume between the rosiglitazone and glipizide groups at 18 months among those treated with a bare metal stent (24.1% vs. 19.8%; P = 0.38) or with a drug-eluting stent (9.8% vs. 8.3%; P = 0.57). QCA data (intra-stent late loss, intra-stent diameter stenosis or binary restenosis) were not different between the rosiglitazone and glipizide groups. This study suggests that both rosiglitazone and glipizide have a similar effect on neointimal growth at medium term follow-up, a finding that warrants investigation in dedicated randomized trials.

Atherosclerosis, IVUS, Restenosis, Type 2 diabetes
dx.doi.org/10.1007/s10554-011-9836-z, hdl.handle.net/1765/62843
International Journal of Cardiovascular Imaging
Department of Cardiology

Garcia-Garcia, H.M, Garg, S.A, Brugaletta, S, Morocutti, G, Ratner, R.E, Kolatkar, N.S, … Jones, P. (2012). Evaluation of in-stent restenosis in the APPROACH trial (assessment on the prevention of progression by Rosiglitazone on atherosclerosis in diabetes patients with cardiovascular history). International Journal of Cardiovascular Imaging, 28(3), 455–465. doi:10.1007/s10554-011-9836-z