Abstract 4563: Effects of Sarpogrelate, a Selective Serotonin Receptor Antagonist, on Vascular Function and Renal Function in Diabetic Patients With Stable Angina and Chronic Kidney Disease
Background: Diabetes mellitus (DM) and Chronic Kidney Disease (CKD) are known as a major risk factor for cardiovascular disease (CVD). Sarpogrelate, a selective serotonin blocker, is known to have not only the inhibitory effects of platelet aggregation and vasoconstriction, but also the improvement of albuminuria. This study was designed to investigate effects of sarpogrelate on vascular function or renal function in diabetic patients with stable angina and chronic kidney disease (CKD).
Methods: After the standard medical therapy, fifty three type 2 diabetic patients with stable angina and CKD (stage 3 or 4) were randomized to receive sarpogrelate (sarpogrelate group, n=26) or not to receive sarpogrelate (control group, n=27). We measured flow-mediated dilatation (FMD) of brachial artery and pulse wave velocity (PWV), and assessed exercise tolerance and renal function (estimated glomerular filtration rate, eGFR). Measurements were performed at baseline, and then at every one year after the treatments. The primary outcome was major adverse cardiovascular events, or hospitalization for revascularization during a follow-up period 5.0 to 5.2 years (median, 5.1 years).
Results: FMD, PWV, exercise tolerance and eGFR were much better in the sarpogrelate group during a follow-up period. The 5.1-year cumulative primary-event rates were 11.5% in the sarpogrelate group and 37.0% in the control group (p=0.031 by long-lank test).
Conclusion: Sarpogrelate, a serotonin blocker, not only improves vascular function (FMD, PWV), exercise tolerance, and eGFR, but also improves long-term outcome in diabetic patients with stable angina and CKD.