Objective To study the effect of Acarbose on myocardial perfusion in revascularized patients with coronary heart disease and impaired glucose tolerance after percutaneous coronary intervention (PCI) and investigate variations of lipid, glucose, and vascular endothelial growth factor (VEGF) levels myocardial perfusion images and cardiac function, as well as the possible mechanisms to improve myocardial perfusion.

Methods Total 102 cases were selected, 5 patients were lost. Finally 97 patients included, 77 males and 20 females, aged 56±13. Of whom, 30 cases suffered from acute myocardial infarction (AMI), 48 from acute coronary syndromes (ACS), and 19 from chronic stable angina pectoris. They were randomised into three groups, A (n=33), B (n=31), and C (n=33) without differences in the baseline level. Normal adults were control group D (n=30). Groups A and B were given by Acarbose 50 mg tid and 100 mg tid, respectively, Groups C and D were given by placebo, the treatment course lasted three months, and CHD patients of each group underwent the same basic treatments after PCI. Myocardial perfusion imaging and variations of blood lipid, IGT, VEGF levels, myocardial perfusion images and cardiac function were observed.

Results 1. The IGT had no statistically differences before treatments in A, B and C groups (p>0.05). The changes of FPG and OGTT 2 h PG levels had statistically differences after treatments in A and B groups (p<0.05), especially B group (p<0.01); The changes of HbA1c had no statistically significant differences after treatments in the four groups (p>0.05); The changes of lipid levels had no statistically differences (p>0.05) before and after treatments in A, B, C and D groups, respectively. 2. A, B, C groups had the significantly higher plasma VEGF levels (203±89 ng/l vs 77±52 ng/l, p<0.01) than D group before treatments. The changes of VEGF levels had statistically differences after treatments in A and B groups (p<0.05), especially B group (p<0.01). The changes of VEGF levels had no statistically differences before and after treatments in C and D groups (p>0.05). 3. The myocardial perfusion images and cardiac function had no statistically differences before treatments in A, B and C groups (p>0.05), The changes of myocardial perfusion images had statistically differences after treatments in A and B groups (p<0.05), especially B group (p<0.01); The changes of cardiac function had statistically differences after treatments in A and B groups (p<0.05), there is no statistically differences after treatments between A and B (p>0.05); The changes of myocardial perfusion images and cardiac function had no statistically differences in C group (p>0.05).

Conclusions Acarbose can regulates IGT, improve myocardial perfusion images and cardiac function. The mechanisms may include reducing VEGF levels, suppressing endothelial hyperplasia, and improving the microcirculation.