Effects of Canagliflozin on Cardiovascular Biomarkers in Older Adults With Type 2 Diabetes
Effects of Canagliflozin on Cardiovascular Biomarkers in Older Adults With Type 2 Diabetes
复制标题
DOI：
10.1016/j.jacc.2017.06.016
复制
发表时间：
2017-08-08
影响因子：
24
通讯作者：
Davies, Michael J.
中科院分区：
文献类型：
--
作者：
Januzzi, James L.;Butler, Javed;Davies, Michael J.
背景钠葡萄糖协同转运蛋白2抑制剂可以降低2型糖尿病（T2 DM）患者的心血管和心力衰竭风险。结论本研究的目的是检测卡格列净对老年T2 DM患者心血管生物标志物的影响。该研究评估了血清N末端B型利钠肽前体的中位百分比变化，结果安慰剂组血清NT-proBNP和血清hsTnI水平均升高，但在随机分配至卡格列净组的患者中基本保持不变。在第26、52和104周，Hodges-Lehmann估计的合并卡格列净和安慰剂之间NT-proBNP的中位百分比变化差异分别为-15.0%、-16.1%和-26.8%，hsTnI分别为-8.3%、-11.9%和-10.0%（所有p < 0.05）。卡格列净和安慰剂治疗104周后血清sST 2未发生变化。卡格列净组与安慰剂组相比，血清半乳糖凝集素-3较基线适度增加，在第26周和第52周观察到显著差异，但在第104周未观察到显著差异。这些结果保持不变时，只有患者完整的样本进行了assessed.CONCLUSIONS相比，安慰剂，治疗卡格列净延迟血清NT-proBNP和hsTnI的上升超过2年的老年T2 DM患者。这些心脏生物标志物数据为钠葡萄糖协同转运蛋白2抑制剂在T2 DM中的有益心血管作用提供了支持。（Canagliflozin在老年2型糖尿病患者[55 - 80岁]中的安全性和疗效研究; NCT 01106651）（C）2017作者。由爱思唯尔代表美国心脏病学会基金会出版。
BACKGROUND Sodium glucose co-transporter 2 inhibitors may reduce cardiovascular and heart failure risk in patients with type 2 diabetes mellitus (T2DM).OBJECTIVES The goal of this study was to examine the effects of canagliflozin on cardiovascular biomarkers in older patients with T2DM.METHODS In 666 T2DM patients randomized to receive canagliflozin 100 or 300 mg or placebo, the study assessed the median percent change in serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hsTnI), soluble (s) ST2, and galectin-3 from baseline to 26, 52, and 104 weeks.RESULTS Both serum NT-proBNP and serum hsTnI levels increased in placebo recipients, but they remained largely unchanged in those randomized to canagliflozin. Hodges-Lehmann estimates of the difference in median percent change between pooled canagliflozin and placebo were -15.0%, -16.1%, and -26.8% for NT-proBNP, and -8.3%, -11.9%, and -10.0% for hsTnI at weeks 26, 52, and 104, respectively (all p < 0.05). Serum sST2 was unchanged with canagliflozin and placebo over 104 weeks. Serum galectin-3 modestly increased from baseline with canagliflozin versus placebo, with significant differences observed at 26 and 52 weeks but not at 104 weeks. These results remained unchanged when only patients with complete samples were assessed.CONCLUSIONS Compared with placebo, treatment with canagliflozin delayed the rise in serum NT-proBNP and hsTnI for over 2 years in older T2DM patients. These cardiac biomarker data provide support for the beneficial cardiovascular effect of sodium glucose co-transporter 2 inhibitors in T2DM. (A Safety and Efficacy Study of Canagliflozin in Older Patients [55 to 80 Years of Age] With Type 2 Diabetes Mellitus; NCT01106651) (C) 2017 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.