ID | 116720 |
Author |
Kusunose, Kenya
Tokushima University
Tokushima University Educator and Researcher Directory
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Imai, Takumi
Osaka City University
Tanaka, Atsushi
Saga University
Dohi, Kaoru
Mie University
Shiina, Kazuki
Tokyo Medical University
Yamada, Takahisa
Osaka General Medical Center
Kida, Keisuke
St. Marianna University School of Medicine
Eguchi, Kazuo
Saitama Red Cross Hospital
Teragawa, Hiroki
JR Hiroshima Hospital
Takeishi, Yasuchika
Fukushima Medical University
Ohte, Nobuyuki
Nagoya City University
Yamada, Hirotsugu
Tokushima University
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Sata, Masataka
Tokushima University
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Node, Koichi
Saga University
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Keywords | Canagliflozin
Type 2 diabetes mellitus
Echocardiography
Diastolic function
NT-proBNP
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Content Type |
Journal Article
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Description | Background: Identification of the effective subtypes of treatment for heart failure (HF) is an essential topic for optimizing treatment of the disorder. We hypothesized that the beneficial effect of SGLT2 inhibitors (SGLT2i) on the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) might depend on baseline diastolic function. To elucidate the effects of SGLT2i in type 2 diabetes mellitus (T2DM) and chronic HF we investigated, as a post-hoc sub-study of the CANDLE trial, the effects of canagliflozin on NT-proBNP levels from baseline to 24 weeks, with the data stratified by left ventricular (LV) diastolic function at baseline.
Methods: Patients (n = 233) in the CANDLE trial were assigned randomly to either an add-on canagliflozin (n = 113) or glimepiride treatment groups (n = 120). The primary endpoint was a comparison between the two groups of the changes from baseline to 24 weeks in NT-pro BNP levels, stratified according to baseline ventricular diastolic function. Results: The change in the geometric mean of NT-proBNP level from baseline to 24 weeks was 0.98 (95% CI 0.89–1.08) in the canagliflozin group and 1.07 (95% CI 0.97–1.18) in the glimepiride group. The ratio of change with canagliflozin/glimepiride was 0.93 (95% CI 0.82–1.05). Responder analyses were used to investigate the response of an improvement in NT-proBNP levels. Although the subgroup analyses for septal annular velocity (SEP-e′) showed no marked heterogeneity in treatment effect, the subgroup with an SEP-e′ < 4.7 cm/s indicated there was an association with lower NT-proBNP levels in the canagliflozin group compared with that in the glimepiride group (ratio of change with canagliflozin/glimepiride (0.83, 95% CI 0.66–1.04). Conclusions: In the subgroup with a lower LV diastolic function, canagliflozin showed a trend of reduced NT-pro BNP levels compared to that observed with glimepiride. This study suggests that the beneficial effects of canagliflozin treatment may be different in subgroups classified by the severity of LV diastolic dysfunction. |
Journal Title |
Cardiovascular Diabetology
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ISSN | 14752840
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Publisher | Springer Nature|BioMed Central
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Volume | 20
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Start Page | 186
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Published Date | 2021-09-14
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Rights | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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language |
eng
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departments |
University Hospital
Medical Sciences
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