Abstract 16542: DPP-4 Inhibition by Alogliptin Improves the Coronary Flow Reserve evaluated by Phase Contrast Cine Magnetic Resonance Imaging in Type 2 Diabetic Patients With Coronary Artery Disease
Background: Dipeptidyl peptidase-4 (DPP4) inhibitors are used for the treatment of Type 2 diabetes mellitus (T2DM) via modulation of glucagon like peptide (GLP-1) function. Phase contrast (PC) cine magnetic resonance imaging (MRI) allows for noninvasive and quantitative evaluation of coronary flow reserve (CFR) without radiation exposure. The aim of this study was to investigate whether DPP-4 inhibition by alogliptin improves CFR in T2DM patients with CAD.
Materials and Methods: Twenty patients (mean age 72.9 ± 9.0 years) T2DM patients with known or suspected CAD were studied by using 1.5T MR scanner equipped with 32 channel cardiac coils. Patients were randomly allocated to two groups (alogliptin group, n=10; control group [glimepiride ± diet therapy], n=10). Breath-hold PC cine MR images of coronary sinus (CS) were obtained to assess the blood flow of CS both at rest and during adenosine triphosphate (ATP) infusion. CFR was calculated as CS blood flow during ATP infusion divided by CS blood flow at rest. CFR by PC cine MRI was evaluated at baseline and 3 month after initiation of therapy.
Results: After the treatment, hemoglobin A1c (HbA1c) was significantly reduced in both groups (alogliptin group, 6.9 ± 0.4% to 6.2 ± 0.3%, p<0.001; control group, 6.6 ± 0.6% to 6.1 ± 0.4%, p=0.048), However, significant improvement of CFR was observed only in alogliptin group (alogliptin group: 2.44 ± 0.58 to 3.23 ± 0.70, p=0.011; control group,2.38 ± 0.73 to 2.59 ± 0.73, p=0.51). Percentage increase in CFR was significantly higher in alogliptin group compared with control group (32.3 ± 18.2% in alogliptin group, 10.6 ± 12.1% in control group, p=0.006).
Conclusion: The results in the current study indicated that DPP-4 inhibition by alogliptin improves the CFR evaluated by PC cine MRI in T2DM patients with CAD.
- © 2013 by American Heart Association, Inc.