Heartbeat: is medical therapy for calcific aortic stenosis possible?
| Autor: | Otto, Catherine M |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Context (language use) 030204 cardiovascular system & hematology Linagliptin medicine.disease Gemigliptin 03 medical and health sciences Stenosis 0302 clinical medicine Valve replacement Sitagliptin Internal medicine medicine Cardiology Vildagliptin 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Alogliptin medicine.drug |
| Zdroj: | Heart |
| ISSN: | 1468-201X 1355-6037 |
| Popis: | There have been a proliferation of data on management of patients with severe calcific aortic stenosis (AS) over the past decade. But, no matter how effective, safe and durable valve replacement turns out to be, we still are treating (or mitigating) only the end-stage of a lengthy disease process. Success in treating calcific AS should be defined as the ability to slow haemodynamic progression or, ultimately, entirely prevent disease in the valve leaflets. In this issue of Heart , Lee and colleagues1 present intriguing data on the association between treatment with a dipeptidyl peptidase-4 (DPP-4) inhibitor and haemodynamic progression of AS in 212 patients (mean age about 73 years) with diabetes and mild-to-moderate AS. Patients taking a DPP-4 inhibitors with a potential favourable anti-calcification ability (such as linagliptin or gemigliptin), compared with those taking an unfavourable DPP-4 inhibitor (such as alogliptin, sitagliptin, or vildagliptin), had a smaller change in aortic velocity and less progression to severe AS (7.1% vs 29%, P −0.03) with an HR of 0.116 (95% CI 0.024 to 0.551, p=0.007) on Cox regression analysis after adjustment for age, baseline renal function and AS severity (figure 1). Figure 1 Changes of maximal transaortic valve velocity (A), mean (B) and peak (C) pressure gradient according to medications. Turkey’s method was used to make box plots. DPP-4, dipeptidyl peptidase-4. Bing and Dweck2 discuss the strengths and limitations of this study in an editorial and put these findings into the context of shared mechanisms between calcific AS and atherosclerosis, … |
| Databáze: | OpenAIRE |
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