Coronary Artery DiseaseImpact of Sitagliptin on Carotid Intima-Media Thickness in Patients With Coronary Artery Disease and Impaired Glucose Tolerance or Mild Diabetes Mellitus
Section snippets
Methods
This study was a prospective, randomized, open-label, single-center, parallel-group, comparative trial. The trial is known as the “early treatment of glucose toxicity with Sitagliptin Prevent progression of ARteriosclerosis in Cardiovascular disease patients” study, was registered at https://center.umin.ac.jp as UMIN 000006432, and was approved by the hospital ethics committee. Participants were recruited from patients admitted to the Department of Cardiology at Anjyo Kosei Hospital (Anjyo,
Results
A total of 80 patients were enrolled in the study, with 40 patients in each group. One patient in the sitagliptin group discontinued antidiabetic therapy owing to drug-related nausea, and 1 patient in each group was withdrawn because of newly identified cardiovascular events. An additional 2 patients in the sitagliptin group were lost to follow-up. Thus, complete baseline and follow-up data were available for 37 patients in the sitagliptin group and 39 in the control group. The baseline
Discussion
This small, prospective, open-label, randomized study demonstrated, for the first time, that 12 months of treatment with sitagliptin was associated with a beneficial effect in terms of preventing the progression of carotid IMT. However, the use of sitagliptin was not associated with a significant decrease in IMT from baseline.
The treatment options for T2DM have expanded since the development of several DPP-4 inhibitors. There is a growing body of evidence that these agents may have protective
Acknowledgment
The authors gratefully acknowledge the technical assistance of Akihiro Suzuki, BSc.
References (24)
- et al.
A dipeptidyl peptidase-4 inhibitor, des-fluoro-sitagliptin, improves endothelial function and reduces atherosclerotic lesion formation in apolipoprotein E-deficient mice
J Am Coll Cardiol
(2012) - et al.
A dipeptidyl peptidase-4 inhibitor, sitagliptin, exerts anti-inflammatory effects in type 2 diabetic patients
Metabolism
(2013) - et al.
Reproducibility of carotid vessel wall thickness measurements. The Rotterdam Study
J Clin Epidemiol
(1994) - et al.
Impact of acarbose on carotid intima-media thickness in patients with newly diagnosed impaired glucose tolerance or mild type 2 diabetes mellitus: a one-year, prospective, randomized, open-label, parallel-group study in Japanese adults with established coronary artery disease
Clin Ther
(2010) - et al.
Atorvastatin 10 mg plus ezetimibe 10mg compared with atorvastatin 20 mg: impact on the lipid profile in Japanese patients with abnormal glucose tolerance and coronary artery disease
J Cardiol
(2012) - et al.
DPP-4 inhibitors and atherosclerosis: the promise
Atherosclerosis
(2013) Dipeptidyl peptidase-4 inhibitor: another player for cardiovascular protection
J Am Coll Cardiol
(2012)- et al.
Hyperglycemia rapidly suppresses flow-mediated endothelium-dependent vasodilation of brachial artery
J Am Coll Cardiol
(1999) - et al.
Metformin attenuates progression of carotid arterial wall thickness in patients with type 2 diabetes
Diabetes Res Clin Pract
(2004) - et al.
Alpha-glucosidase inhibitor reduces the progression of carotid intima-media thickness
Diabetes Res Clin Pract
(2005)
Effect of statins alone versus statins plus ezetimibe on carotid atherosclerosis in type 2 diabetes: the SANDS (Stop Atherosclerosis in Native Diabetics Study) trial
J Am Coll Cardiol
Review of sitagliptin phosphate: a novel treatment for type 2 diabetes
Vasc Health Risk Manag
Cited by (46)
The treament of hyperglycemia in acute ischemic stroke with incretin-based drugs
2020, Pharmacological ResearchThe protective role of DPP4 inhibitors in atherosclerosis
2020, European Journal of PharmacologySitagliptin attenuates the progression of coronary atherosclerosis in patients with coronary disease and type 2 diabetes
2020, AtherosclerosisCitation Excerpt :Since the introduction of DPP-4 inhibitors, many in vivo studies have demonstrated these classes of oral hypoglycemic agents had effects on the prevention of atherosclerosis progression independent of glucose-reducing effects [15,29,30]. Moreover, several clinical studies assessed the effects of DPP-4 inhibitors on carotid intima-media thickness (IMT) in T2DM and found that sitagliptin attenuated the progression of carotid IMT in insulin-treated patients with T2DM free of apparent cardiovascular disease compared with conventional treatment [17,18]. In this study, we further demonstrated DPP-4 inhibitors sitagliptin could stabilize coronary atherosclerosis plaque assessed by 3D-QCA analysis in patients with diabetes.
Impact of dipeptidyl-peptidase 4 inhibitors on cardiovascular diseases
2018, Vascular PharmacologyCitation Excerpt :In the study performed by Ishikawa et al.,newly diagnosed with impaired glucose tolerance or mild T2MD patients had received either sitagliptin 100 mg/day or the placebo for 12 months. Results showed that sitagliptin was associated with a beneficial effect in the prevention of carotid IMT progression [61]. Data from a 12-week prospective, randomized, open-label parallel group trial showed that both sitagliptin and vildagliptin treatment resulted in a significant decline in IMT in patients with T2DM.
Changes in coronary atherosclerosis, composition, and fractional flow reserve evaluated by coronary computed tomography angiography in patients with type 2 diabetes
2018, IJC Heart and VasculatureCitation Excerpt :However, the effects of this class of drug on the progression of atherosclerosis are controversial in the clinical setting. Previous studies have reported that sitagliptin improves endothelial function [24,25] and has a beneficial effect on carotid intima-media thickness [13,26]. Furthermore, it has been reported that alogliptin attenuates the progression of carotid intima-media thickness [12].
This work was supported by grant YRY1311 from Yokoyama Foundation for Clinical Pharmacology, Nagoya, Japan to Dr. Shimano.
This trial is registered at http://center.umin.ac.jp; unique identifier: UMIN (University Hospital Medical Information Network) 000006432.
See page 387 for disclosure information.