Apabetalone and hospitalization for heart failure in patients following an acute coronary syndrome: a prespecified analysis of the BETonMACE study

Autor: Stephen J. Nicholls, Gregory G. Schwartz, Kevin A. Buhr, Henry N. Ginsberg, Jan O. Johansson, Kamyar Kalantar-Zadeh, Ewelina Kulikowski, Peter P. Toth, Norman Wong, Michael Sweeney, Kausik K. Ray, the BETonMACE Investigators
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Endocrinology
Diabetes and Metabolism
Type 2 diabetes
030204 cardiovascular system & hematology
Cardiorespiratory Medicine and Haematology
Cardiovascular
0302 clinical medicine
Patient Admission
BET inhibitors
Original Investigation
0303 health sciences
Diabetes
Middle Aged
Cardiovascular disease
Clinical trial
Treatment Outcome
Heart Disease
BETonMACE Investigators
6.1 Pharmaceuticals
Female
Epigenetics
Acute coronary syndrome
Cardiology and Cardiovascular Medicine
Type 2
medicine.medical_specialty
Clinical Trials and Supportive Activities
Heart failure
Placebo
Patient Readmission
03 medical and health sciences
Double-Blind Method
Clinical Research
Diabetes mellitus
Internal medicine
medicine
Diabetes Mellitus
Humans
Acute Coronary Syndrome
Heart Disease - Coronary Heart Disease
030304 developmental biology
Angiology
Aged
Quinazolinones
business.industry
Evaluation of treatments and therapeutic interventions
Cardiovascular Agents
medicine.disease
Atherosclerosis
Diabetes Mellitus
Type 2
Cardiovascular System & Hematology
lcsh:RC666-701
business
Mace
Zdroj: Cardiovascular Diabetology, Vol 20, Iss 1, Pp 1-9 (2021)
Cardiovascular diabetology, vol 20, iss 1
Cardiovascular Diabetology
ISSN: 1475-2840
Popis: Background Patients with diabetes and acute coronary syndrome (ACS) are at high risk for subsequent heart failure. Apabetalone is a selective inhibitor of bromodomain and extra-terminal (BET) proteins, epigenetic regulators of gene expression. Preclinical data suggest that apabetalone exerts favorable effects on pathways related to myocardial structure and function and therefore could impact subsequent heart failure events. The effect of apabetalone on heart failure events after an ACS is not currently known. Methods The phase 3 BETonMACE trial was a double-blind, randomized comparison of apabetalone versus placebo on the incidence of major adverse cardiovascular events (MACE) in 2425 patients with a recent ACS and diabetes. This prespecified secondary analysis investigated the impact of apabetalone on hospitalization for congestive heart failure, not previously studied. Results Patients (age 62 years, 74.4% males, 90% high-intensity statin use, LDL-C 70.3 mg/dL, HDL-C 33.3 mg/dL and HbA1c 7.3%) were followed for an average 26 months. Apabetalone treated patients experienced the nominal finding of a lower rate of first hospitalization for heart failure (2.4% vs. 4.0%, HR 0.59 [95%CI 0.38–0.94], P = 0.03), total number of hospitalizations for heart failure (35 vs. 70, HR 0.47 [95%CI 0.27–0.83], P = 0.01) and the combination of cardiovascular death or hospitalization for heart failure (5.7% vs. 7.8%, HR 0.72 [95%CI 0.53–0.98], P = 0.04). Conclusion Apabetalone treatment was associated with fewer hospitalizations for heart failure in patients with type 2 diabetes and recent ACS. Future studies are warranted to define the potential for BET inhibition with apabetalone to prevent heart failure in patients with diabetes and ACS.
Databáze: OpenAIRE
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