Empagliflozin attenuates neointimal hyperplasia after drug-eluting-stent implantation in patients with type 2 diabetes

Autor: Takehiro Hashikata, Susumu Katsushika, Masaaki Yokoyama, Mikio Kishi, Masao Yamasaki, Takahiro Jimba, Satoshi Ohnishi, Takahiro Sato, Masashiro Matsushita, Nobutaka Kakuda, Akito Shindo, Masayasu Ikutomi
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Type 2 diabetes
Coronary Artery Disease
030204 cardiovascular system & hematology
Hematocrit
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Glucosides
Japan
Diabetes mellitus
Internal medicine
Neointima
medicine
Empagliflozin
Humans
030212 general & internal medicine
Prospective Studies
Benzhydryl Compounds
Sodium-Glucose Transporter 2 Inhibitors
Aged
Neointimal hyperplasia
Hyperplasia
medicine.diagnostic_test
business.industry
Drug-Eluting Stents
Middle Aged
medicine.disease
Coronary Vessels
Blood pressure
Treatment Outcome
Diabetes Mellitus
Type 2
Drug-eluting stent
Cardiology
Female
sense organs
Cardiology and Cardiovascular Medicine
business
Tomography
Optical Coherence
Zdroj: Heart and vessels. 35(10)
ISSN: 1615-2573
Popis: The effects of empagliflozin, a sodium-glucose co-transporter 2 inhibitor, on neointimal response after drug-eluting-stent (DES) implantation remains unknown. Insufficiently controlled diabetes patients with coronary artery disease planned for DES stenting were consecutively enrolled. The patients were assigned to receive empagliflozin in addition to standard therapy or intensive therapy using other glucose-lowering drugs (oGLD). The primary endpoint was thickness of neointimal hyperplasia (NIH) 12 months after stenting assessed by optical coherence tomography (OCT). A total of 28 patients were analyzed (n = 15 in the empagliflozin group, n = 13 in the oGLD group). The levels of glucose profile were not significantly different between both groups at follow-up [HbA1c; 7.2 ± 0.8 vs 7.3 ± 0.9%, p = 0.46]. In OCT analysis, neointima was significantly less in the empagliflozin group than the oGLD group [mean NIH thickness: 137 ± 32 vs 168 ± 39 μm, p = 0.02]. Changes of systolic and diastolic blood pressure (BP), changes of body mass index, and changes of hematocrit after additional treatment were significantly associated with NIH attenuation, whereas no correlation was observed in changes in blood glucose parameters. Multivariate logistic regression analysis revealed that changes in systolic BP was the strongest predictor for NIH attenuation, followed by changes in diastolic BP. In patients with type 2 diabetes, standard plus empagliflozin attenuated neointimal progression as compared with intensive standard therapy after DES implantation. Our data possibly support a beneficial effect of empagliflozin in type 2 diabetes required for coronary revascularization therapy.
Databáze: OpenAIRE
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