背景:
近來許多研究顯示，thiazolidinediones(TZDs)可降低非塗藥支架手術後血管支架內的再狹窄，進而減少血管再手術的發生。隨著塗藥支架的使用越來越普遍，但有關塗藥支架與TZDs的研究仍付之闕如。
目的:
探討第二型糖尿病患者置放塗藥支架手術後服用TZDs對其心肌梗塞、血管再手術與死亡之影響。
研究方法:
本研究採回溯性世代觀察研究之設計，以2005年到2008年之全民健保資料庫進行分析。研究對象為2006年12月1日到2007年12月31日第一次置放塗藥支架之第二型糖尿病患者，並依支架上所塗的藥物將塗藥支架分成limus類塗藥支架與paclitaxel塗藥支架兩組。以手術出院後90天內之降血糖藥用藥情形分成TZD組與non-TZD組，且其用藥需在發生不良反應前。並運用Cox proportional hazard model之統計方法，分別比較其出院後一年內之血管再手術、心肌梗塞、死亡預後情形。並以propensity score校正其結果。
結果:
個案數共1743人 (TZD組268人；non-TZD組1475人)，其中limus類塗藥支架655人 (TZD組113人；non-TZD組542人)，paclitaxel塗藥支架1088人 (TZD組155人；non-TZD組933人)。TZD組相較於non-TZD組，在血管再手術發生風險部分皆無顯著差異:未分支架種類(HR=0.853, 95%CI:0.575–1.267)；limus類塗藥支架(HR=0.764, 95%CI:0.382–1.527)；paclitaxel塗藥支架(HR=0.905, 95%CI: 0.554–1.480)。在心肌梗塞發生風險部分亦皆無顯著差異:未分支架種類(HR=1.228, 95%CI: 0.723–2.088)；limus類塗藥支架(HR=0.930, 95%CI: 0.341–2.536)；paclitaxel塗藥支架(HR=1.376, 95%CI: 0.728–2.599)。而在心肌梗塞或死亡的發生風險部分一樣皆無顯著差異:未分支架種類(HR=1.204, 95%CI: 0.73–1.985)；limus類塗藥支架(HR=0.868, 95%CI: 0.320–2.35)；paclitaxel塗藥支架(HR=1.344, 95%CI: 0.746–2.422)。最後在重大心血管事件(包括血管再手術、心肌梗塞、死亡)的發生風險部分亦皆無顯著差異:未分支架種類(HR=0.961, 95%CI: 0.682–1.355)；limus類塗藥支架(HR=0.900, 95%CI:0.496–1.632)；paclitaxel塗藥支架(HR=0.981, 95%CI: 0.637–1.509)。
進一步的分層分析中，置放limus類塗藥支架且有心肌梗塞病史之病患，術後服用TZDs似乎有較高心肌梗塞發生風險(HR= 5.292, 95%CI: 1.028 – 27.232)，其它皆未有顯著差異。另在使用TZDs的族群中，limus類塗藥支架與paclitaxel塗藥支架的之預後亦未有顯著差異。
結論:
本研究之結果顯示，第二型糖尿病患無論是置放limus類塗藥支架或是paclitaxel塗藥支架，術後服用TZDs皆未發現其對血管在手術、心肌梗塞、死亡與重大心血管事件有顯著的改善。但有心肌梗塞病史且置放limus塗藥支架之病患，術後服用TZDs似乎有較高心肌梗塞發生風險。未來仍需較大型且長時間的研究來加以釐清。

Background
Recent studies have demonstrated that thiazolidinediones (TZDs) may reduce in-stent restenosis and improve clinical outcomes in patients with type 2 diabetes after bare-metal stent implantation. However, with the widespread use of drug-eluting stent(DES), it is still unknown whether diabetic patients with DES could also benefit from the treatment with TZDs.Our study focused on the effects of TZDs on clinical outcomes of diabetic patients after DES implantation.

Objectives
To compare clinical outcomes of type 2 diabetic patients with and without TZDs therapy after receiving DES.

Methods
We conducted a retrospective cohort study using the National Health Insurance Database (NHIRD) to identify 1,743 patients with type 2 diabetes mellitus and received the first limus-eluting stent or paclitaxel-eluting stent placement from December 1, 2006, through December 31, 2007. Follow-up data were available through December 31, 2008. Patients were classified into TZD group(n=268) or non-TZD group(n=1475) based on the antidiabetic agents they took from pharmacy records within 3 months after the index hospitalization . Our measure of effectiveness was the prevalence of death, myocardial infarction and repeat revascularization(percutaneous coronary intervention, coronary artery bypass surgery) within one year after index hospitalization. The Cox proportional hazards model and other analyses were performed in this study.

Results
Between TZD group and non-TZD group, there were no significant difference in adjusted hazard ratio of death, myocardial infarction and repeat revascularization, whether patients received limus-eluting stent or paclitaxel-eluting stent. In stratified analysis, patients who received limus-eluting stent with history of myocardial infarction and treated with TZDs were associated with a higher risk of myocardial infarction (HR= 5.292, 95%CI: 1.028 – 27.232). To Compare patients who received limus-eluting stent with those who received paclitaxel-eluting stent in TZD group, the adjusted hazard of adverse events within one year were no significant difference.

Conclusion
Our findings suggest that TZDs could not improve clinical outcomes in type 2 diabetes patients after drug-eluting stent implantation. TZDs may contribute to higher risk of myocardial infarction in patient with limus-eluting stent and history of myocardial infarction. Larger clinical trials are still needed to further clarify the clinical outcome of TZDs therapy after drug-eluting stent implantation .

目次
中文摘要 i
Abstract iii
目次 v
表次 vii
圖次 viii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 3
第三節 研究問題 3
第二章 文獻探討 4
第一節 冠狀動脈血管支架 4
第二節 糖尿病 15
第三節 Thiazolidinediones(TZDs) 20
第四節 Thiazolidinedione類藥物與血管支架 26
第三章 研究方法 37
第一節 研究設計 37
第二節 研究架構 39
第三節 研究假設 41
第四節 資料來源與個案選取 42
第五節 研究變項定義及測量 44
第六節 資料處理與統計分析 56
第四章 研究結果 60
第一節 置放塗藥支架術後有無使用thiazolidinediones之預後分析 61
第二節 置放limus類塗藥支架術後有無使用thiazolidinediones之預後分析 76
第三節 置放paclitaxel類塗藥支架術後有無使用thiazolidinediones之預後分析 92
第四節 Limus類塗藥支架與paclitaxel塗藥支架術後有無使用TZDs對其預後之分層分析 107
第五節 使用thiazolidinediones族群對置放limus類塗藥支架與paclitaxel塗藥支架之預後分析 110
第五章 討論 125
第一節 研究結果之討論 125
第二節 研究方法之討論 129
第三節 研究限制 132
第六章 結論與建議 133
第一節 結論 133
第二節 建議 134
參考文獻 135
附錄 146

1. 詹建富. 聯合新聞網健康醫藥 心血管支架給付 每年3支變4支. http://mag.udn.com/mag/life/storypage.jsp?f_MAIN_ID=207&f_SUB_ID=455&f_ART_ID=172367. Accessed 01/14, 2009.
2. Kuchulakanti PK, Chu WW, Torguson R, et al. Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents. Circulation 2006;113:1108-1113.
3. Frobert O, Lagerqvist B, Carlsson J, Lindback J, Stenestrand U, James SK. Differences in restenosis rate with different drug-eluting stents in patients with and without diabetes mellitus a report from the SCAAR (swedish angiography and angioplasty registry). J Am Coll Cardiol 2009;53:1660-1667.
4. Stone GW, Ellis SG, Cox DA, et al. A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med 2004;350:221.
5. Daemen J, Wenaweser P, Tsuchida K, et al. Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: Data from a large two-institutional cohort study. The Lancet 2007;369:667-678.
6. Mauri L, Hsieh W, Massaro JM, Ho KKL, D'Agostino R, Cutlip DE. Stent thrombosis in randomized clinical trials of drug-eluting stents. N Engl J Med 2007;356:1020.
7. Cutlip DE, Baim DS, Ho KKL, et al. Stent thrombosis in the modern era : A pooled analysis of multicenter coronary stent clinical trials. Circulation 2001;103:1967-1971.
8. Iakovou I, Schmidt T, Bonizzoni E, et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA 2005;293:2126-2130.
9. Cutlip DE, Windecker S, Mehran R, et al. Clinical end points in coronary stent trials: A case for standardized definitions. Circulation 2007;115:2344.
10. Urban P, Gershlick AH, Guagliumi G, et al. Safety of coronary sirolimus-eluting stents in daily clinical practice: One-year follow-up of the E-CYPHER registry. Circulation 2006;113:1434-1441.
11. Billinger M, Beutler J, Taghetchian KR, et al. Two-year clinical outcome after implantation of sirolimus-eluting and paclitaxel-eluting stents in diabetic patients. Eur Heart J 2008;29:718-725.
12. Geng DF, Jin DM, Wu W, Wang Z, Wang JF. Effect of thiazolidinediones on in-stent restenosis in patients after coronary stenting: A meta-analysis of randomized controlled trials. Atherosclerosis 2009;202:521-528.
13. Elte JWF, Blickle JF. Thiazolidinediones for the treatment of type 2 diabetes. European Journal of Internal Medicine 2007;18:18-25.
14. 黃瑞仁, 及種類. 冠狀動脈心臟病的診斷與治療. 中華民國內膜異位症婦女協會會刊 2008;15:7-14.
15. 程俊傑. 急性心肌梗塞的最新治療. 中華民國急救加護醫學會雜誌 2000;11:1-9.
16. Shih C, Berliner E. Diffusion of new technology and payment policies: Coronary stents. Health Aff (Millwood) 2008;27:1566.
17. Fischman DL, Leon MB, Baim DS, et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 1994;331:496-501.
18. Moses JW, Leon MB, Popma JJ, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 2003;349:1315.
19. Hermiller JB, Raizner A, Cannon L, et al. Outcomes with the polymer-based paclitaxel-eluting TAXUS stent in patients with diabetes mellitus the taxus-iv trial. J Am Coll Cardiol 2005;45:1172-1179.
20. Woods TC, Marks AR. Drug-eluting stents. Ann Acad Med Singapore 2004;33:423-431.
21. 中央健康保險局. 特殊材料. 2009年12月; http://www.nhi.gov.tw/.
22. Sehgal SN. Sirolimus: Its discovery, biological properties, and mechanism of action. Transplant Proc 2003;35:S7-S14.
23. Marks AR. Sirolimus for the prevention of in-stent restenosis in a coronary artery. N Engl J Med 2003;349:1307.
24. Costa MA, Simon DI. Molecular basis of restenosis and drug-eluting stents. Circulation 2005;111:2257-2273.
25. 翁德昌, 蔡慧珊, 高雅慧. Sirolimus 塗藥支架之應用. 臺灣醫學 2007;11:216-223.
26. Rowinsky EK, Donehower RC. Paclitaxel (taxol). N Engl J Med 1995;332:1004.
27. Axel DI, Kunert W, Goggelmann C, et al. Paclitaxel inhibits arterial smooth muscle cell proliferation and migration in vitro and in vivo using local drug delivery. Circulation 1997;96:636-645.
28. Kukreja N, Onuma Y, Daemen J, Serruys PW. The future of drug-eluting stents. Pharmacol Res 2008;57:171-180.
29. Morice MC, Serruys PW, Sousa JE, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med 2002;346:1773.
30. Morice MC, Serruys PW, Barragan P, et al. Long-term clinical outcomes with sirolimus-eluting coronary stents: Five-year results of the RAVEL trial. J Am Coll Cardiol 2007;50:1299-1304.
31. Weisz G, Leon MB, Holmes Jr DR, et al. Five-year follow-up after sirolimus-eluting stent implantation: Results of the SIRIUS (sirolimus-eluting stent in de-novo native coronary lesions) trial. J Am Coll Cardiol 2009;53:1488-1497.
32. Schofer J, Schluter M, Gershlick AH, et al. Sirolimus-eluting stents for treatment of patients with long atherosclerotic lesions in small coronary arteries: Double-blind, randomised controlled trial (E-SIRIUS). The Lancet 2003;362:1093-1099.
33. Schampaert E, Cohen EA, Schluter M, et al. The canadian study of the sirolimus-eluting stent in the treatment of patients with long de novo lesions in small native coronary arteries (C-SIRIUS). J Am Coll Cardiol 2004;43:1110-1115.
34. Grube E, Silber S, Hauptmann KE, et al. TAXUS I: Six- and twelve-month results from a randomized, double-blind trial on a slow-release paclitaxel-eluting stent for de novo coronary lesions. Circulation 2003;107:38-42.
35. Silber S, Colombo A, Banning AP, et al. Final 5-year results of the TAXUS II trial: A randomized study to assess the effectiveness of slow- and moderate-release polymer-based paclitaxel-eluting stents for de novo coronary artery lesions. Circulation 2009;120:1498-1504.
36. Stone GW, Ellis SG, Cox DA, et al. One-year clinical results with the slow-release, polymer-based, paclitaxel-eluting TAXUS stent: The TAXUS-IV trial. Circulation 2004;109:1942.
37. Stone GW, Ellis SG, Cannon L, et al. Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: A randomized controlled trial. JAMA 2005;294:1215.
38. Grube E, Dawkins KD, Guagliumi G, et al. TAXUS VI 2-year follow-up: Randomized comparison of polymer-based paclitaxel-eluting with bare metal stents for treatment of long, complex lesions. Eur Heart J 2007;28:2578.
39. Morice MC, Colombo A, Meier B, et al. Sirolimus-vs paclitaxel-eluting stents in de novo coronary artery lesions: The REALITY trial: A randomized controlled trial. JAMA 2006;295:895.
40. Galloe AM, Thuesen L, Kelbaek H, et al. Comparison of paclitaxel-and sirolimus-eluting stents in everyday clinical practice: The SORT OUT II randomized trial. JAMA 2008;299:409.
41. Dibra A, Kastrati A, Mehilli J, et al. Paclitaxel-eluting or sirolimus-eluting stents to prevent restenosis in diabetic patients. N Engl J Med 2005;353:663.
42. Maeng M, Jensen LO, Galloe AM, et al. Comparison of the sirolimus-eluting versus paclitaxel-eluting coronary stent in patients with diabetes mellitus: The diabetes and drug-eluting stent (DiabeDES) randomized angiography trial. Am J Cardiol 2009;103:345-349.
43. Tomai F, Reimers B, De Luca L, et al. Head-to-head comparison of sirolimus- and paclitaxel-eluting stent in the same diabetic patient with multiple coronary artery lesions. Diabetes Care 2008;31:15-19.
44. Moo Hyun Kim, Soon Jun H, Kwang Soo Cha, et al. Effect of paclitaxel-eluting versus sirolimus-eluting stents on coronary restenosis in korean diabetic patients. J Intervent Cardiol 2008;21:225-231.
45. Lee SW PS, Kim YH,, Yun S-C, Park D-W, et al. A randomized comparison of sirolimus- versus paclitaxel-eluting stent implantation in patients with diabetes mellitus: 2-year clinical outcomes of the des-diabetes trial. J Am Coll Cardiol 2009;53:812-813.
46. Mahmud E, Bromberg-Marin G, Palakodeti V, Ang L, Creanga D, DeMaria AN. Clinical efficacy of drug-eluting stents in diabetic patients: A meta-analysis. J Am Coll Cardiol 2008;51:2385.
47. Kastrati A, Schomig A, Dietz R, Neumann FJ, Richardt G. Time course of restenosis during the first year after emergency coronary stenting. Circulation 1993;87:1498-1505.
48. Douglas JJS. Role of adjunct pharmacologic therapy in the era of drug-eluting stents. Atherosclerosis Supplements 2005;6:47-52.
49. Sabate M, Jimenez-Quevedo P, Angiolillo DJ, et al. Randomized comparison of sirolimus-eluting stent versus standard stent for percutaneous coronary revascularization in diabetic patients: The diabetes and sirolimus-eluting stent (DIABETES) trial. Circulation 2005;112:2175-2183.
50. Joner M, Finn AV, Farb A, et al. Pathology of drug-eluting stents in humans delayed healing and late thrombotic risk. J Am Coll Cardiol 2006;48:193-202.
51. Pfisterer M, Brunner-La Rocca HP, Buser PT, et al. Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents an observational study of drug-eluting versus bare-metal stents. J Am Coll Cardiol 2006;48:2584-2591.
52. Spaulding C, Daemen J, Boersma E, Cutlip DE, Serruys PW. A pooled analysis of data comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med 2007;356:989.
53. King III SB, Smith Jr SC, Hirshfeld Jr JW, Jacobs AK, Morrison DA, Williams DO. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: A report of the American College of Cardiology/American Heart Association task force on practice guidelines: 2007 writing group to review new evidence and update the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention, writing on behalf of the 2005 writing committee. Circulation 2008;117:261.
54. 國家衛生研究院. 2009年12月; http://www.nhri.org.tw/NHRI_WEB/nhriw001Action.do?status=Show_Dtl&nid=20090618282556880000&uid=20081204954976470000.
55. Gavin III JR, Alberti K, Davidson MB, et al. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1997;20:1183–1197.
56. Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care 2003;26:1902.
57. 黃錦鳳, 張明利, 蔡仁貞. 一位糖尿病急性併發症病患之護理經驗. 慈濟護理雜誌 2004;3:97-107.
58. Campbell RK. Type 2 diabetes: Where we are today: An overview of disease burden, current treatments, and treatment strategies. Journal of the American Pharmacists Association 2009;49:3-9.
59. 陳建良, 謝昌勳. 第 2 型糖尿病之藥物. 臺灣醫學 2008;12:231-238.
60. Nathan DM, Buse JB, Davidson MB, et al. Medical management of hyperglycaemia in type 2 diabetes mellitus: A consensus algorithm for the initiation and adjustment of therapy. Diabetologia 2009;52:17-30.
61. 沈德昌, 顏兆熊. 第 2 型糖尿病藥物治療新知. 臺灣醫界 2008;51:466-471.
62. Gale EAM. Lessons from the glitazones: A story of drug development. The Lancet 2001;357:1870-1875.
63. 行政院衛生署. 藥物許可證查詢. 2009年12月; http://203.65.100.151/DO8180.asp.
64. Yki-Jarvinen H. Thiazolidinediones. N Engl J Med 2004;351:1106-1118.
65. Inzucchi SE. Oral antihyperglycemic therapy for type 2 diabetes: Scientific review. JAMA 2002;287:360.
66. Scheen AJ. Hepatotoxicity with thiazolidinediones: Is it a class effect? Drug Saf 2001;24:873-888.
67. Lebovitz HE, Kreider M, Freed MI. Evaluation of liver function in type 2 diabetic patients during clinical trials. Diabetes Care 2002;25:815.
68. Nesto RW, Bell D, Bonow RO, et al. Thiazolidinedione use, fluid retention, and congestive heart failure: A consensus statement from the american heart association and american diabetes association. Circulation 2003;108:2941.
69. Kahn SE, Haffner SM, Heise MA, et al. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. N Engl J Med 2006;355:2427.
70. Meier C, Kraenzlin ME, Bodmer M, Jick SS, Jick H, Meier CR. Use of thiazolidinediones and fracture risk. Arch Intern Med 2008;168:820.
71. Hsiao FY, Mullins C. The association between thiazolidinediones and hospitalisation for fracture in type 2 diabetic patients: A taiwanese population-based nested case–control study. Diabetologia 2009.
72. Gilling L, Suwattee P, DeSouza C, Asnani S, Fonseca V. Effects of the thiazolidinediones on cardiovascular risk factors. American Journal of Cardiovascular Drugs 2002;2:149-156.
73. Nissen SE, Nicholls SJ, Wolski K, et al. Comparison of pioglitazone vs glimepiride on progression of coronary atherosclerosis in patients with type 2 diabetes: The PERISCOPE randomized controlled trial. JAMA 2008;299:1561.
74. Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med 2007;356:2457-2471.
75. Singh S, Loke YK, Furberg CD. Long-term risk of cardiovascular events with rosiglitazone: A meta-analysis. JAMA 2007;298:1189.
76. Dormandy JA, Charbonnel B, Eckland DJA, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive study (PROspective pioglitAzone Clinical Trial In macroVascular Events): A randomised controlled trial. The Lancet 2005;366:1279-1289.
77. Lincoff AM, Wolski K, Nicholls SJ, Nissen SE. Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: A meta-analysis of randomized trials. JAMA 2007;298:1180.
78. Nagajothi N, Adigopula S, Balamuthusamy S, et al. Pioglitazone and the risk of myocardial infarction and other major adverse cardiac events: A meta-analysis of randomized, controlled trials. Am J Ther 2008;15:506.
79. Hsiao FY, Huang WF, Wen YW, Chen PF, Kuo KN, Tsai YW. Thiazolidinediones and cardiovascular events in patients with type 2 diabetes mellitus: A retrospective cohort study of over 473000 patients using the national health insurance database in taiwan. Drug Saf 2009;32:675-690.
80. Denver C. Fluid retention with thiazolidinediones. J Am Coll Cardiol 2007;49:16.
81. Lago RM, Singh PP, Nesto RW. Congestive heart failure and cardiovascular death in patients with prediabetes and type 2 diabetes given thiazolidinediones: A meta-analysis of randomised clinical trials. The Lancet 2007;370:1129-1136.
82. Bishop-Bailey D, Hla T, Warner TD. Intimal smooth muscle cells as a target for peroxisome proliferator-activated receptor-{gamma} ligand therapy. Circ Res 2002;91:210-217.
83. de Dios ST, Bruemmer D, Dilley RJ, et al. Inhibitory activity of clinical thiazolidinedione peroxisome proliferator activating receptor-{gamma} ligands toward internal mammary artery, radial artery, and saphenous vein smooth muscle cell proliferation. Circulation 2003;107:2548-2550.
84. Ronald EL, Woerner PM, Xiao-Ping Xi. Troglitazone inhibits vascular smooth muscle cell growth and intimal hyperplasia. J Clin Invest 1996;98:1897-1905.
85. Hsueh WA, Jackson S, Law RE. Control of vascular cell proliferation and migration by PPAR-γ a new approach to the macrovascular complications of diabetes. Diabetes Care 2001;24:392-397.
86. Schoonjans K, Auwerx J. Thiazolidinediones: An update. The Lancet 2000;355:1008-1010.
87. Cao Z, Zhou Y. Thiazolidinediones may be effective in the prevention of stent thrombosis with DES. Med Hypotheses 2008;70:329-332.
88. Osman A, Otero J, Brizolara A, et al. Effect of rosiglitazone on restenosis after coronary stenting in patients with type 2 diabetes. Am Heart J 2004;147:e23.
89. Nishio K, Shigemitsu M, Kodama Y, Konno N, Katagiri T, Kobayashi Y. Comparison of bare metal stent with pioglitazone versus sirolimus-eluting stent for percutaneous coronary intervention in patients with type 2 diabetes mellitus. Cardiovascular Revascularization Medicine 2009;10:5-11.
90. Kaneda H, Shiono T, Miyashita Y, et al. Efficacy and safety of pioglitazone in patients with ST-elevation myocardial infarction treated with primary stent implantation. Heart 2009.
91. Katayama T, Ueba H, Tsuboi K, et al. Reduction of neointimal hyperplasia after coronary stenting by pioglitazone in nondiabetic patients with metabolic syndrome. Am Heart J 2007;153:762 e761-767.
92. Fang CC, Jao Y. Angiographic and clinical outcomes of rosiglitazone in patients with type 2 diabetes mellitus after percutaneous coronary interventions: A single center experience. Angiology 2007;58:523.
93. Nishio K, Sakurai M, Kusuyama T, et al. A randomized comparison of pioglitazone to inhibit restenosis after coronary stenting in patients with type 2 diabetes. Diabetes Care 2006;29:101.
94. Takagi T, Yamamuro A, Tamita K, Katayama M, Morioka S. Thiazolidinedione treatment attenuates diffuse neointimal hyperplasia in restenotic lesions after coronary stent implantation in type 2 diabetic patients: An intravascular ultrasound study. J Cardiol 2005;45:139-147.
95. Marx N, Wohrle J, Nusser T, et al. Pioglitazone reduces neointima volume after coronary stent implantation: A randomized, placebo-controlled, double-blind trial in nondiabetic patients. Circulation 2005;112:2792-2798.
96. Choi D, Kim SK, Choi SH, et al. Preventative effects of rosiglitazone on restenosis after coronary stent implantation in patients with type 2 diabetes. Diabetes Care 2004;27:2654-2660.
97. Takagi T, Yamamuro A, Tamita K, et al. Pioglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with type 2 diabetes mellitus: An intravascular ultrasound scanning study. Am Heart J 2003;146:366-366.
98. Finn AV, Oh JS, Hendricks M, et al. Predictive factors for in-stent late loss and coronary lesion progression in patients with type 2 diabetes mellitus randomized to rosiglitazone or placebo. Am Heart J 2009;157:383.
99. Rosmarakis ES, Falagas ME. Effect of thiazolidinedione therapy on restenosis after coronary stent implantation: A meta-analysis of randomized controlled trials. Am Heart J 2007;154:144-150.
100. Cao Z, Zhou YJ, Zhao YX, Liu YY, Guo YH, Cheng WJ. Rosiglitazone could improve clinical outcomes after coronary stent implantation in nondiabetic patients with metabolic syndrome. Chin Med J (Engl) 2006;119:1171-1175.
101. Cho L, Lewis BE, Steen LH, Leya FS. Thiazolidinediones do not reduce target vessel revascularization in diabetic patients undergoing percutaneous coronary intervention. Cardiology 2005;104:97-100.
102. Riche DM, Valderrama R, Henyan NN. Thiazolidinediones and risk of repeat target vessel revascularization following percutaneous coronary intervention: A meta-analysis. Diabetes Care 2007;30:384.
103. Ozawa T, Oda H, Oda M, et al. Improved cardiac function after sirolimus-eluting stent placement in diabetic patients by pioglitazone: Combination therapy with statin. J Cardiol 2009;53:402-409.
104. Wang G, Wei J, Guan Y, Jin N, Mao J, Wang X. Peroxisome proliferator–activated receptor-γ agonist rosiglitazone reduces clinical inflammatory responses in type 2 diabetes with coronary artery disease after coronary angioplasty. Metabolism 2005;54:590-597.
105. Yokoyama J, Sutoh N, Higuma T, et al. Efficacy and safety of low-dose pioglitazone after primary coronary angioplasty with the use of bare metal stent in patients with acute myocardial infarction and with type 2 diabetes mellitus or impaired glucose tolerance. Heart Vessels 2007;22:146-151.
106. Rosmarakis ES, Falagas ME. Effect of thiazolidinedione therapy on restenosis after coronary stent implantation: A meta-analysis of randomized controlled trials. Am Heart J 2007;154:144-150.
107. Kaneda H, Shiono T, Miyashita Y, et al. Efficacy and safety of pioglitazone in patients with ST elevation myocardial infarction treated with primary stent implantation. Br Med J 2009;95:1079.
108. Smith SC, Feldman TE, Hirshfeld JW, et al. ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention a report of the American College of Cardiology/American Heart Association task force on practice guidelines (ACC/AHA/SCAI writing committee to update the 2001 guidelines for percutaneous coronary intervention). J Am Coll Cardiol 2006;47:1-121.
109. Gershlick AH. Drug eluting stents in 2005. Br Med J 2005;91:iii24-iii31.
110. Piper WD, Malenka DJ, Ryan TJ, et al. Predicting vascular complications in percutaneous coronary interventions. Am Heart J 2003;145:1022-1029.
111. Park DW, Park SW, Park KH, et al. Frequency of and risk factors for stent thrombosis after drug-eluting stent implantation during long-term follow-up. Am J Cardiol 2006;98:352-356.
112. O’Connor GT, Malenka DJ, Quinton H, et al. Multivariate prediction of in-hospital mortality after percutaneous coronary interventions in 1994–1996. J Am Coll Cardiol 1999;34:681-691.
113. 台北榮民總醫院. 認識冠狀動脈血管支架術. http://www.gandau.gov.tw/nurse/inout%20nurse/heart/h008.htm. Accessed 12月, 2009.
114. Walter LC, Brand RJ, Counsell SR, et al. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization. JAMA 2001;285:2987.
115. Lexis CP, Rahel BM, Meeder JG, Zijlstra F, van der Horst IC. The role of glucose lowering agents on restenosis after percutaneous coronary intervention in patients with diabetes mellitus. Cardiovasc Diabetol 2009;8:41.
116. Kapinya K, Nijjar PS, Stanek M, Amanullah A. Insulin-sensitizing antihyperglycaemic medications are associated with better outcome in patients with diabetes undergoing cardiac stress testing. Internal Medicine Journal 2008;38:259-264.
117. Garratt KN, Brady PA, Hassinger NL, Grill DE, Terzic A, Holmes DR. Sulfonylurea drugs increase early mortality in patients with diabetes mellitus after direct angioplasty for acute myocardial infarction. J Am Coll Cardiol 1999;33:119-124.
118. Kao J, Tobis J, McClelland RL, et al. Relation of metformin treatment to clinical events in diabetic patients undergoing percutaneous intervention. Am J Cardiol 2004;93:1347-1350.
119. Romano PS, Roos LL, Jollis JG. Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: Differing perspectives. J Clin Epidemiol 1993;46:1075.
120. Bhargava B, Karthikeyan G, Abizaid AS, Mehran R. New approaches to preventing restenosis. BMJ 2003;327:274-279.
121. Schomig A, Kastrati A, Wessely R. Prevention of restenosis by systemic drug therapy: Back to the future? Circulation 2005;112:2759-2761.
122. Finn AV, Joner M, Nakazawa G, et al. Pathological correlates of late drug-eluting stent thrombosis: Strut coverage as a marker of endothelialization. Circulation 2007;115:2435.
123. Finn AV, John M, Nakazawa G, et al. Differential healing after sirolimus, paclitaxel, and bare metal stent placement in combination with peroxisome proliferator-activator receptor {gamma} agonists: Requirement for mTOR/Akt2 in PPAR{gamma} activation. Circ Res 2009;105:1003-1012.