Slide 1

Effect of Aleglitazar on Cardiovascular Outcomes After Acute Coronary Syndrome in Patients With Type 2 Diabetes MellitusThe AleCardio Randomized Clinical Trial

Michael Lincoff, M.D. for the AleCardio InvestigatorsDirector, C5Research(Cleveland Clinic Coordinating Center for Clinical Research)Vice Chairman of Cardiovascular MedicineProfessor of MedicineLate Breaking Clinical Trials ACC 2014

AML1Effects of / PPAR ActivationNuclear receptors that function as transcription factors regulating the expression of genes Insulin sensitivityaPrimary g effect is to improve insulin sensitivityg Fatty acid oxidation VLDL-TG Fatty acid uptake Anti-inflammatory apo AI, HDL Primary a effect is to improve plasma lipid profile Beta cellfunction fatty acid uptake Adiponectin secretion Anti-inflammatory

heart, liver, muscle, vasculatureAdipocytes

Muscle

AMLPioglitazone - PPAR g ActivatorLincoff et al. JAMA 2007;298:1180-1188.Meta-AnalysisDeath, MI, or Stroke 16,390 Pts

HR = 0.82 (95% CI, 0.72-0.94)p = 0.005PERISCOPE TrialCoronary Intravascular UltrasoundNissen et al. JAMA 2008;299:1561.

p