Yuta Kato , Atsushi Iwata , Bo Zhang , Shin-ichiro Miura , Satoshi Imaizumi , Takashi Kuwano , Amane Ike , Makoto Sugihara , Hiroaki Nishikawa , Shin'ichiro Yasunaga , Keijiro Saku
{"title":"二肽基肽酶-4抑制剂西格列汀对2型糖尿病合并冠心病患者冠状动脉粥样硬化的影响","authors":"Yuta Kato , Atsushi Iwata , Bo Zhang , Shin-ichiro Miura , Satoshi Imaizumi , Takashi Kuwano , Amane Ike , Makoto Sugihara , Hiroaki Nishikawa , Shin'ichiro Yasunaga , Keijiro Saku","doi":"10.1016/j.ijcme.2017.06.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>It is unclear whether the addition of dipeptidyl peptidase-4 inhibitors (DPP4-I) to statins may cause coronary plaque regression in type 2 diabetes mellitus (T2DM) patients with coronary artery disease (CAD).</p></div><div><h3>Methods and results</h3><p>Seventy-five T2DM patients with CAD who underwent percutaneous coronary intervention under intravascular ultrasound (IVUS) guidance were randomized to receive DPP4-I sitagliptin (sitagliptin group) or not to receive DPP4-I (non-DPP4-I group) as an add-on treatment to statins, and were followed-up for 8–12<!--> <!-->months. Patients with analyzable IVUS examinations of the non-culprit segment were included in the primary analysis. Sitagliptin group (<em>n</em> <!-->=<!--> <!-->28) and non-DPP4-I group (<em>n</em> <!-->=<!--> <!-->24) had significant (<em>p</em> <!--><<!--> <!-->0.05) and similar reduction in low-density lipoprotein cholesterol levels (−<!--> <!-->12<!--> <!-->±<!--> <!-->24 and −<!--> <!-->12<!--> <!-->±<!--> <!-->23<!--> <!-->mg/dL), and had no significant changes in hemoglobin A<sub>1c</sub> levels. Nominal change in percent atheroma volume (PAV), the primary endpoint, was not significant in both the sitagliptin and non-DPP4-I groups [mean (95% CI): +<!--> <!-->1.1% (−<!--> <!-->0.5 to 2.7%) and 0.2% (−<!--> <!-->1.5 to 1.9%)]. The difference in change in PAV between sitagliptin and non-DPP4-I groups was also not significant [0.89% (−<!--> <!-->1.46%–3.25%)].</p></div><div><h3>Conclusions</h3><p>The addition of sitagliptin to statins did not cause coronary plaque regression in T2DM with CAD.</p></div>","PeriodicalId":73333,"journal":{"name":"IJC metabolic & endocrine","volume":"16 ","pages":"Pages 1-9"},"PeriodicalIF":0.0000,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijcme.2017.06.005","citationCount":"3","resultStr":"{\"title\":\"Effects of dipeptidyl peptidase-4 inhibitor sitagliptin on coronary atherosclerosis as assessed by intravascular ultrasound in type 2 diabetes mellitus with coronary artery disease\",\"authors\":\"Yuta Kato , Atsushi Iwata , Bo Zhang , Shin-ichiro Miura , Satoshi Imaizumi , Takashi Kuwano , Amane Ike , Makoto Sugihara , Hiroaki Nishikawa , Shin'ichiro Yasunaga , Keijiro Saku\",\"doi\":\"10.1016/j.ijcme.2017.06.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>It is unclear whether the addition of dipeptidyl peptidase-4 inhibitors (DPP4-I) to statins may cause coronary plaque regression in type 2 diabetes mellitus (T2DM) patients with coronary artery disease (CAD).</p></div><div><h3>Methods and results</h3><p>Seventy-five T2DM patients with CAD who underwent percutaneous coronary intervention under intravascular ultrasound (IVUS) guidance were randomized to receive DPP4-I sitagliptin (sitagliptin group) or not to receive DPP4-I (non-DPP4-I group) as an add-on treatment to statins, and were followed-up for 8–12<!--> <!-->months. Patients with analyzable IVUS examinations of the non-culprit segment were included in the primary analysis. Sitagliptin group (<em>n</em> <!-->=<!--> <!-->28) and non-DPP4-I group (<em>n</em> <!-->=<!--> <!-->24) had significant (<em>p</em> <!--><<!--> <!-->0.05) and similar reduction in low-density lipoprotein cholesterol levels (−<!--> <!-->12<!--> <!-->±<!--> <!-->24 and −<!--> <!-->12<!--> <!-->±<!--> <!-->23<!--> <!-->mg/dL), and had no significant changes in hemoglobin A<sub>1c</sub> levels. Nominal change in percent atheroma volume (PAV), the primary endpoint, was not significant in both the sitagliptin and non-DPP4-I groups [mean (95% CI): +<!--> <!-->1.1% (−<!--> <!-->0.5 to 2.7%) and 0.2% (−<!--> <!-->1.5 to 1.9%)]. The difference in change in PAV between sitagliptin and non-DPP4-I groups was also not significant [0.89% (−<!--> <!-->1.46%–3.25%)].</p></div><div><h3>Conclusions</h3><p>The addition of sitagliptin to statins did not cause coronary plaque regression in T2DM with CAD.</p></div>\",\"PeriodicalId\":73333,\"journal\":{\"name\":\"IJC metabolic & endocrine\",\"volume\":\"16 \",\"pages\":\"Pages 1-9\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ijcme.2017.06.005\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IJC metabolic & endocrine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214762417300154\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJC metabolic & endocrine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214762417300154","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Effects of dipeptidyl peptidase-4 inhibitor sitagliptin on coronary atherosclerosis as assessed by intravascular ultrasound in type 2 diabetes mellitus with coronary artery disease
Background
It is unclear whether the addition of dipeptidyl peptidase-4 inhibitors (DPP4-I) to statins may cause coronary plaque regression in type 2 diabetes mellitus (T2DM) patients with coronary artery disease (CAD).
Methods and results
Seventy-five T2DM patients with CAD who underwent percutaneous coronary intervention under intravascular ultrasound (IVUS) guidance were randomized to receive DPP4-I sitagliptin (sitagliptin group) or not to receive DPP4-I (non-DPP4-I group) as an add-on treatment to statins, and were followed-up for 8–12 months. Patients with analyzable IVUS examinations of the non-culprit segment were included in the primary analysis. Sitagliptin group (n = 28) and non-DPP4-I group (n = 24) had significant (p < 0.05) and similar reduction in low-density lipoprotein cholesterol levels (− 12 ± 24 and − 12 ± 23 mg/dL), and had no significant changes in hemoglobin A1c levels. Nominal change in percent atheroma volume (PAV), the primary endpoint, was not significant in both the sitagliptin and non-DPP4-I groups [mean (95% CI): + 1.1% (− 0.5 to 2.7%) and 0.2% (− 1.5 to 1.9%)]. The difference in change in PAV between sitagliptin and non-DPP4-I groups was also not significant [0.89% (− 1.46%–3.25%)].
Conclusions
The addition of sitagliptin to statins did not cause coronary plaque regression in T2DM with CAD.
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