Effects of Canagliflozin on Cardiovascular Biomarkers in Older Adults With Type 2 Diabetes

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:70

Article

Januzzi, James L.¹  Butler, Javed²  Jarolim, Petr³  Sattar, Naveed⁴  Vijapurkar, Ujjwala⁵  Desai, Mehul⁵  Davies, Michael J.⁶ 

[1] Harvard Med Sch, Massachusetts Gen Hosp, Dept Med Div Cardiol, Boston, MA USA

[2] SUNY Stony Brook, Cardiol Div, Stony Brook, NY 11794 USA

[3] Harvard Med Sch, Brigham & Womens Hosp, Dept Pathol, Boston, MA USA

[4] Univ Glasgow, Inst Cardiovasc & Med Sci, British Heart Fdn Ctr, Glasgow, Lanark, Scotland

[5] Janssen Res & Dev LLC, Raritan, NJ USA

[6] Janssen Sci Affairs LLC, Titusville, NJ USA

关键词: cardiovascular stress;    galectin-3;    high-sensitivity troponin;    N-terminal pro-B-type natriuretic peptide;    sodium glucose co-transporter 2 inhibitor;    soluble ST2;   

DOI  :  10.1016/j.jacc.2017.06.016

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

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