Abstract 2452: Long-term Effects of Sarpogrelate HCl, a Selective Serotonin Receptor Antagonist, in Diabetic Patients with Stable Angina
Background: Sarpogrelate HCl, a selective serotonin blocker, is known to have not only the inhibitory effects of platelet aggregation and vasoconstriction, but also the improvement of insulin resistance in type 2 diabetic state. This study was designed to investigate long-term outcome of sarpogrelate in diabetic patients with stable angina.
Methods: After the standard medical therapy, forty two patients with type 2 diabetic mellitus and stable angina were randomized to receive sarpogrelate HCl (sarpogrelate group, 300mg/day, n=21) or not to receive sarpogrelate HCl (control group, n=21). The primary outcome was hospitalization for acute coronary syndrome or revascularization during a follow-up period 4.2 to 4.7 years (median, 4.4 years). We measured flow-mediated dilatation (FMD) of brachial artery and pulse wave velocity (PWV), and assessed exercise tolerance and insulin resistance (HOMA-IR).
Results: The 4.4-year cumulative primary-event rates were 9.5% in the sarpogrelate group and 38.1% in the control group (p<0.05 by long-lank test). FMD, PWV, exercise tolerance and HOMA-IR were more superior in the sarpogrelate group during a follow-up period.
Conclusion: Sarpogrelate HCl, a serotonin blocker, not only improves vascular function (FMD, PWV), exercise tolerance, and insulin resistance, but also improves long-term outcome in diabetic patients with stable angina.