Effects of Pemafibrate on Cardio-Ankle Vascular Index (CAVI) in Patients with Type 2 Diabetes or Ischemic Heart Disease: A 24-Week Observational Study.

IF 2.6 Q2 PERIPHERAL VASCULAR DISEASE

Vascular Health and Risk Management Pub Date : 2025-04-24 eCollection Date: 2025-01-01 DOI:10.2147/VHRM.S506642

Yasuhiro Watanabe, Shoya Nonaka, Shuhei Yamaoka, Shoko Nakamura, Osamu Horikawa, Takashi Yamaguchi, Shuji Sato, Shunsuke Todani, Yuta Sugizaki, Takuro Ito, Hiroshi Mikamo, Mao Takahashi, Daiji Nagayama, Kazuhiro Shimizu, Atsuhito Saiki

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引用次数: 0

Abstract

Purpose: Pemafibrate is a novel selective peroxisome proliferator-activated receptor alpha modulator (SPPARMα) that improves lipid profile, but its effects on cardiovascular events remain unproven. This study examined changes in the cardio-ankle vascular index (CAVI), a marker of arterial stiffness, in high-risk patients with type 2 diabetes mellitus (T2DM) or ischemic heart disease (IHD) treated with pemafibrate.

Patients and methods: In this single-center, prospective, observational study, 95 patients with T2DM and/or IHD, who had hypertriglyceridemia (≥150 mg/dL) and started pemafibrate (0.2 mg/day) were analyzed. CAVI was measured at baseline and after 24 weeks of treatment as an indicator of arterial stiffness, along with comprehensive assessment of lipid parameters including triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and apolipoproteins.

Results: No significant change in CAVI was observed after 24 weeks of treatment (median [interquartile range (IQR)]; baseline vs 24 weeks: CAVI 9.4 [8.8-10.6] vs 9.6 [8.9-10.8], p=0.715). However, pemafibrate significantly reduced triglycerides (233 mg/dL [171-329] to 143 mg/dL [111-187], p<0.001), apolipoprotein C-II (8.1 mg/dL [6.1-10.2] to 6.3 mg/dL [5.3-8.3], p<0.001), apolipoprotein C-III (15.3 mg/dL [12.2-18.3] to 11.6 mg/dL [9.3-14.2], p<0.001) and liver enzymes; and increased HDL-C (45 mg/dL [39-52] to 50 mg/dL [40-60], p<0.001), LDL-C (92 mg/dL [70-111] to 103 mg/dL [79-128], p<0.001), apolipoprotein A-I and apolipoprotein A-II (both p<0.05). Calculated small dense low-density lipoprotein cholesterol also decreased significantly (40 mg/dL [31-49] to 36 mg/dL [28-45], p=0.002).

Conclusion: While pemafibrate improves lipid profile and liver enzymes, its short-term impact on vascular stiffness, as measured by CAVI, appears limited. Extended follow-up studies are needed to clarify its cardiovascular benefits in high-risk patients.

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培马布特对2型糖尿病或缺血性心脏病患者心踝血管指数（CAVI）的影响：一项为期24周的观察性研究

目的：pemafbrate是一种新型的选择性过氧化物酶体增殖物激活受体α调节剂（SPPARMα），可改善血脂，但其对心血管事件的影响尚未得到证实。本研究检测了2型糖尿病（T2DM）或缺血性心脏病（IHD）高危患者接受培马颤治疗后的心踝血管指数（CAVI）的变化，CAVI是动脉硬度的标志。患者和方法：在这项单中心、前瞻性、观察性研究中，研究人员分析了95例伴有高甘油三酯血症（≥150mg /dL）并开始使用帕玛菲特（0.2 mg/天）的T2DM和/或IHD患者。在基线和治疗24周后测量CAVI，作为动脉僵硬度的指标，同时综合评估脂质参数，包括甘油三酯、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、非HDL-C和载脂蛋白。结果：治疗24周后CAVI无显著变化(中位数[四分位数间距（IQR）]；基线vs 24周：CAVI 9.4 [8.8-10.6] vs 9.6 [8.9-10.8], p=0.715)。然而，培马哌啶可显著降低甘油三酯（233 mg/dL[171-329]至143 mg/dL[111-187]）。结论：尽管培马哌啶可改善血脂和肝酶，但其对CAVI测量的血管僵硬度的短期影响似乎有限。需要进一步的随访研究来阐明其对高危患者的心血管益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vascular Health and Risk Management PERIPHERAL VASCULAR DISEASE-

CiteScore

4.20

自引率

3.40%

发文量

109

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.