Rosiglitazone Improves Glucose Uptake In The Heart

Rosiglitazone therapy significantly improved myocardial glucose uptake in type 2 diabetic patients with ischemic coronary artery disease. Rosiglitazone improves insulin sensitivity and skeletal muscle glucose uptake in patients with uncomplicated type 2 diabetes. In patients with ischemic coronary artery disease, glucose is an important source of energy and preserved myocardial glucose uptake is essential for the viability of the jeopardised myocardium. The effect of rosiglitazone on myocardial metabolism in type 2 diabetic patients with coronary artery disease is unknown.

The study was randomized, double-blind and placebo-controlled. 54 patients (38 men, 16 women) with type 2 diabetes (HbA1c 7.2+0.9%) and coronary artery disease were studied with PET and [18F]FDG during hyperinsulinemic euglycemic clamp before and after 16 week intervention period with rosiglitazone (n=27) or placebo (n=27). Ischemic regions of myocardium were determined with rest-stress 99m Tc-SPECT imaging and coronary angiography.

Myocardial glucose uptake was enhanced by 24% in ischemic region (P=0.023) and by 29% in non-ischemic region (P=0.003) in rosiglitazone group as compared to placebo group when adjusted with gender and baseline. Furthermore, when myocardial glucose uptake was corrected with myocardial workload, glucose uptake was increased by 28% in ischemic (P=0.035) and by 33% in non-ischemic (P=0.006) region in rosiglitazone group vs. placebo. In addition, whole body insulin sensitivity and glycemic control were significantly improved in rosiglitazone group vs. placebo group.

From the results, it was shown that rosiglitazone therapy significantly improves myocardial glucose uptake in type 2 diabetic patients with ischemic coronary artery disease. These results suggest that rosiglitazone therapy may facilitate myocardial glucose storage and utilization in these patients.

Presented last week at the 54th Annual Scientific Session of the American College of Cardiology.Riikka Lautamäki1, MD, K.E. Juhani Airaksinen1, MD, FESC