Abstract 11806: Not Glycemic Control Using Sitagliptin But Lipid Control is Associated With Change in Coronary Atherosclerosis in Patients With Type 2 Diabetes -A Serial Integrated Backscatter Intravascular Ultrasound Study
Abstract
Introduction:
Dipeptidyl peptidase-4 (DPP-4) inhibitors have anti-atherogenic effects in an animal model. However, clinical usefulness of DPP-4 inhibitors, particularly effects of these drugs on coronary atherosclerosis has not been fully evaluated.
Hypothesis:
We assessed the hypothesis that sitagliptin, a DPP-4 inhibitor, has beneficial effects on coronary atherosclerosis beyond its hypoglycemic action.
Methods:
A prospective, open-labeled, randomized multicenter study was performed at 6 Japanese centers. Twenty-eight patients with type 2 diabetes who have undergone elective percutaneous coronary intervention (PCI) were randomly assigned to either the sitagliptin group (group S) or control group (group C). Neither DPP-4 inhibitors nor glucagon-like peptide-1 analogues have been used in group C during study period. Non- PCI lesions were evaluated by integrated backscatter (IB)-intravascular ultrasound (IVUS) at the time of PCI and at 48-week follow-up. The primary end point was percentage change in plaque volume measured using grayscale IVUS and the secondary end point was changes in plaque compositions measured using IB-IVUS.
Results:
Grayscale IVUS analysis demonstrated that plaque volume tended to be decreased in both groups (group S: -1.7%; group C: -3.2%), but could not reach statistically significance. In addition, percentage changes in plaque volume did not differ between the 2 groups. On IB-IVUS analysis, a significant decrease in the lipid component (group S: from…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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