ID | 115096 |
Author |
Tanaka, Atsushi
Saga University
Hisauchi, Itaru
Dokkyo Medical University
Taguchi, Isao
Dokkyo Medical University
Sezai, Akira
Nihon University
Toyoda, Shigeru
Dokkyo Medical University
Tomiyama, Hirofumi
Tokyo Medical University
Sata, Masataka
Tokushima University
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Ueda, Shinichiro
University of the Ryukyus
Oyama, Jun-ichi
Saga University
Kitakaze, Masafumi
National Cerebral and Cardiovascular Center
Murohara, Toyoaki
Nagoya University
Node, Koichi
Saga University
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Keywords | Type 2 diabetes
Heart failure
SGLT2 inhibitor
NT-proBNP
Non-inferiority
Glimepiride
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Content Type |
Journal Article
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Description | Aims
Little is known about the impact of sodium glucose co‐transporter 2 (SGLT2) inhibitors on cardiac biomarkers, such as natriuretic peptides, in type 2 diabetes (T2D) patients with concomitant chronic heart failure (CHF). We compared the effect of canagliflozin with glimepiride, based on changes in N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), in that patient population. Methods and results Patients with T2D and stable CHF, randomized to receive canagliflozin 100 mg or glimepiride (starting‐dose: 0.5 mg), were examined using the primary endpoint of non‐inferiority of canagliflozin vs. glimepiride, defined as a margin of 1.1 in the upper limit of the two‐sided 95% confidence interval (CI) for the group ratio of percentage change in NT‐proBNP at 24 weeks. Data analysis of 233 patients showed mean left ventricular ejection fraction (LVEF) at randomization was 57.6 ± 14.6%, with 71% of patients having a preserved LVEF (≥50%). Ratio of NT‐proBNP percentage change was 0.48 (95% CI, −0.13 to 1.59, P = 0.226) and therefore did not meet the prespecified non‐inferiority margin. However, NT‐proBNP levels did show a non‐significant trend lower in the canagliflozin group [adjusted group difference; −74.7 pg/mL (95% CI, −159.3 to 10.9), P = 0.087] and also in the subgroup with preserved LVEF [−58.3 (95% CI, −127.6 to 11.0, P = 0.098]). Conclusions This study did not meet the predefined primary endpoint of changes in NT‐proBNP levels, with 24 weeks of treatment with canagliflozin vs. glimepiride. Further research is warranted to determine whether patients with heart failure with preserved ejection fraction, regardless of diabetes status, could potentially benefit from treatment with SGLT2 inhibitors. |
Journal Title |
ESC Heart Failure
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ISSN | 20555822
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Publisher | The Heart Failure Association of the European Society of Cardiology|Wiley
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Volume | 7
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Issue | 4
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Start Page | 1585
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End Page | 1594
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Published Date | 2020-04-29
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Rights | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License(https://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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language |
eng
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Publisher
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departments |
Medical Sciences
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