Abstract 13577: A Selective SGLT2 Inhibitor Early Resolutes Metabolic and Arterial Disturbances in Type-2 Diabetics With Coronary Artery Disease
Introduction: Diabetes mellitus is thought to be highly involved in complex metabolic and atherothrombogenic disturbances, but the effective therapies in patients with type-2 diabetes mellitus have not been established.
Hypothesis: We assessed hypothesis a selective SGLT2 (Sodium Glucose co-Transporter 2) inhibitor, a recently developed antidiabetic agent, promptly reverses complex metabolic and atherothrombogenic disturbances in patients with type-2 diabetes mellitus.
Methods: Type-2 diabetic patients with stable coronary artery disease were randomized to group-SG where they received antidiabetic therapy with a selective SGLT2 inhibitor for 2 weeks, or to group-C where they continued therapy without an inhibitor against SGLT2. We quantified flow-mediated endothelium-dependent dilatation of brachial artery after 5 minutes forearm occlusion (FMD), and intima-media thickness of brachial artery (IMT) using high-resolution ultrasonography. Changes in FMD, IMT, and other practical metabolic variables from the baseline through the follow-up point were compared between the 2 groups.
Results: All the patients in group-SG (n=10) manifested good compliance to the treatment and improvements in metabolic variables represented by blood glucose, systolic blood pressure, body weight, and high sensitive CRP (mg/dL: from 0.15±0.07 to 0.11±0.04, p=0.01), while those in group-C (n=10) showed no improvement. FMD (%) increased after medication in group-SG (from 3.5±1.3 to 4.8±1.8, p=0.01), while it remained unchanged in group-C (from 3.4±1.3 to 3.5±1.9, p=0.82). IMT (mm) decreased after medication in group-SG (from 0.34±0.08 to 0.31±0.06, p=0.04), while it remained unchanged in group-C (0.35±0.08 to 0.36±0.05, p=0.88). Changes of FMD or IMT in group-SG did not correlate to those of blood glucose (FMD: r=0.09, p=0.89, IMT: r=0.13, p=0.78).
Conclusions: These results indicate selective inhibition of SGLT2 in diabetic patients early improves metabolic status and furthermore improves arterial status independent of reversal for glycemic status, which may have novel potential benefit of a selective SGLT2 inhibitor for management of progressive metabolic and atherothrombogenic disturbances in type-2 diabetics with coronary artery disease.
Author Disclosures: T. Murakami: None. S. Mizuno: None.
- © 2014 by American Heart Association, Inc.