Abstract 13063: Dapagliflozin Provides Multiple Ultrasonic-Evaluated Antiatherosclerotic Effects Independent of Diabetic Improvement for Type-2 Diabetics With Coronary Artery Disease Receiving Statin or Sartan
Introduction: Diabetes mellitus is thought to be highly involved in complex atherothrombogenic processes, but the antiatherosclerotic therapies in patients with type-2 diabetes mellitus have not been established.
Hypothesis: We assessed hypothesis that antidiabetic therapy with dapagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, pleiotropically inhibits atherosclerotic progression in patients with type-2 diabetes mellitus treated by statin or sartan, one of the best possible antiatherosclerotic therapies.
Methods: Type-2 diabetic patients with stable coronary artery disease taking statin or sartan were randomized to group-D where they received antidiabetic therapy with dapagliflozin for 6 months, or to group-C where they received enhanced therapies with conventional antidiabetic agents without an SGLT2 inhibitor. We quantified flow-mediated endothelium-dependent dilatation of brachial artery after transient forearm occlusion (FMD), and also quantified intima-media thickness of brachial artery (IMT) using high-resolution ultrasonography. Changes in FMD, IMT, and other metabolic variables were compared between the 2 groups.
Results: Glycemic variables represented by HbA1c significantly improved in both groups. All patients in group-D (n=20) manifested good compliance and significant improvements in multiple metabolic variables, while those in group-C (n=10) showed no improvement. In group-D FMD (%) significantly increased (from 3.4±2.5 to 6.3±2.3, p<0.01) and IMT (mm) significantly decreased (from 0.33±0.06 to 0.30±0.05, p=0.04), while both FMD (from 3.6±2.3 to 3.8±2.4, p=0.72) and IMT (from 0.34±0.12 to 0.35±0.14, p=0.84) remained unchanged in group-C. Changes of FMD or IMT in group-D did not correlate to those of HbA1c (FMD: r=0.14, p=0.69, IMT: r=0.10, p=0.72).
Conclusions: These results indicate inhibition of sodium glucose co-transporter-2 with dapagliflozin improves endothelial function, and reduces arterial wall thickening independent of glucose lowering, which may have novel potential benefit of dapagliflozin for management of progressive atherosclerosis in type-2 diabetics with coronary artery disease treated by statin or sartan one of the best possible antiatherosclerotic therapies.
Author Disclosures: T. Murakami: None. K. Ohsato: None.
- © 2016 by American Heart Association, Inc.