The Role of Pioglitazone in Vascular Transcriptional Remodeling in Individuals Undergoing Coronary Artery Bypass Grafting

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 4
SUMMARY

Acute myocardial infarction (AMI) remains the leading cause of death worldwide. In this scenario, early coronary reperfusion is the main therapeutic strategy as it substantially reduces mortality. Paradoxically, however, reperfusion triggers additional tissue damage that accounts for about 50% of the infarcted heart mass, i.e., ischemia and reperfusion injury (IRL). In this context, sphingosine-1-phosphate (S1P) is a sphingolipid synthesized by sphingosine kinases (Sphk), carried in plasma bound to high-density lipoprotein (HDL) and released after cellular damage such as LIR. Particularly, in animal models of AMI, therapies targeting downstream S1P receptor signaling triggered by HDL/S1P are able to promote endothelial barrier functions and attenuate secondary damage to LIR. Thus, the molecular control of sphingosine kinase 1 (Sphk1) transcription during LIR in vivo or during hypoxia/reoxygenation (H/R) in vitro may represent an important mechanism for maintaining endothelial homeostasis since it promotes the generation of S1P and this may promote subsequent HDL enrichment. Thus, the role of pioglitazone hydrochloride 45mg/day for five days in volunteers undergoing coronary artery bypass grafting (BVR) will be investigated in order to verify the vascular expression of SPhk1, transcriptome and vascular proteome remodeling, as well as S1P content in HDL.

Eligibility
Participation Requirements
Sex: Male
Minimum Age: 40
Maximum Age: 70
Healthy Volunteers: f
View:

• Male individuals

• Individuals undergoing CABG surgery for coronary artery disease

• Be over 40 years of age

• BMI between 20 and 34.9kg/m2

• Non-diabetic or if diabetic, disease duration \< 10 years, Hba1c \< 8%, non-user of NPH insulin

• Ejection fraction \> 40%

• Glomerular filtration rate \> 45 mL/min

Locations
Other Locations
Brazil
University of Campinas
RECRUITING
Campinas
Contact Information
Primary
Andrei Sposito, Professor
sposito@unicamp.br
+551935218788
Backup
Isabella Bonilha, biomedical
ibonilha@unicamp.br
+551935217959
Time Frame
Start Date: 2023-06-15
Estimated Completion Date: 2024-12-22
Participants
Target number of participants: 20
Treatments
Active_comparator: Pioglitazone
Research participants will be randomized to receive pioglitazone hydrochloride 45mg/day for 5 days prior to coronary artery bypass surgery.
No_intervention: Placebo
Research participants will be randomized to not receive intervention in the days prior to coronary artery bypass graft surgery.
Sponsors
Leads: University of Campinas, Brazil

This content was sourced from clinicaltrials.gov