ID | 114509 |
Author |
Yamada, Hirotsugu
Tokushima University
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Tanaka, Atsushi
Saga University
Kusunose, Kenya
Tokushima University
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Amano, Rie
Tokushima University
Matsuhisa, Munehide
Tokushima University
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Daida, Hiroyuki
Juntendo University
Ito, Masaaki
Mie University
Tsutsui, Hiroyuki
Kyushu University
Nanasato, Mamoru
Japanese Red Cross Nagoya Daini Hospital
Kamiya, Haruo
Japanese Red Cross Nagoya Daiichi Hospital
Bando, Yasuko K.
Nagoya University
Odawara, Masato
Tokyo Medical University
Yoshida, Hisako
Saga University
Murohara, Toyoaki
Nagoya University
Sata, Masataka
Tokushima University
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Node, Koichi
Saga University
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Keywords | Sitagliptin
T2DM
Echocardiography
Diastolic function
NT-proBNP
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Content Type |
Journal Article
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Description | Background: Diabetes is associated closely with an increased risk of cardiovascular events, including diastolic dysfunction and heart failure that leads to a shortening of life expectancy. It is therefore extremely valuable to evaluate the impact of antidiabetic agents on cardiac function. However, the influence of dipeptidyl peptidase 4 inhibitors on cardiac function is controversial and a major matter of clinical concern. We therefore evaluated the effect of sitagliptin on echocardiographic parameters of diastolic function in patients with type 2 diabetes as a sub-analysis of the PROLOGUE study.
Methods: Patients in the PROLOGUE study were assigned randomly to either add-on sitagliptin treatment or conventional antidiabetic treatment. Of the 463 patients in the overall study, 115 patients (55 in the sitagliptin group and 60 in the conventional group) who had complete echocardiographic data of the ratio of peak early diastolic transmitral flow velocity (E) to peak early diastolic mitral annular velocity (e′) at baseline and after 12 and 24 months were included in this study. The primary endpoint of this post hoc sub-analysis was a comparison of the changes in the ratio of E to e′ (E/e′) between the two groups from baseline to 24 months. Results: The baseline-adjusted change in E/e′ during 24 months was significantly lower in the sitagliptin group than in the conventional group (−0.18 ± 0.55 vs. 1.91 ± 0.53, p = 0.008), irrespective of a higher E/e′ value at baseline in the sitagliptin group. In analysis of covariance, sitagliptin treatment was significantly associated with change in E/e′ over 24 months (β = −9.959, p = 0.001), independent of other clinical variables at baseline such as blood pressure, HbA1c, and medications for diabetes. Changes in other clinical variables including blood pressure and glycemic parameters, and echocardiographic parameters, such as cardiac structure and systolic function, were comparable between the two groups. There was also no significant difference in the serum levels of N-terminal-pro brain natriuretic peptide and high-sensitive C-reactive protein between the two groups during the study period. Conclusions: Adding sitagliptin to conventional antidiabetic regimens in patients with T2DM for 24 months attenuated the annual exacerbation in the echocardiographic parameter of diastolic dysfunction (E/e′) independent of other clinical variables such as blood pressure and glycemic control. |
Journal Title |
Cardiovascular Diabetology
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ISSN | 14752840
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Publisher | Springer Nature|BioMed Central
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Volume | 16
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Start Page | 63
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Published Date | 2017-05-11
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Rights | © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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.
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language |
eng
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Publisher
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departments |
University Hospital
Institute of Advanced Medical Sciences
Medical Sciences
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