AI Article Synopsis
- Patients with type 2 diabetes are at high risk for coronary artery disease (CAD) and recent advancements like fractional flow reserve (FFR) from CCTA are being used to analyze CAD more effectively.
- The study will investigate the effects of the DPP-4 inhibitor alogliptin on coronary atherosclerosis in these patients, focusing on changes in FFR and plaque volume over a 48-week treatment period.
- This will be the first multicenter trial using FFR as a primary endpoint to assess the anti-atherogenic effects of alogliptin, potentially shedding light on its benefits for managing CAD in diabetic patients.
Article Abstract
Background: Patients with type 2 diabetes are at high risk for developing coronary artery disease (CAD). Noninvasive anatomic assessment by coronary computed tomography angiography (CCTA) is being increasingly used for detecting or excluding CAD. Recently, fractional flow reserve (FFR) using routinely acquired CCTA datasets (FFR) has been developed. Although intensive glycemic control can reduce the risk of microvascular complications, intensive glucose control does not seem to be beneficial in preventing major cardiovascular events when compared with standard therapy. However, it has been reported that dipeptidyl peptidase-4 (DPP-4) inhibitors have anti-atherogenic effects in an animal model. In addition, DPP-4 inhibitors attenuate the progression of carotid intima-media thickness in patients with type 2 diabetes. Therefore, this study will be performed to evaluate the effects of alogliptin, a DPP-4 inhibitor, on coronary atherosclerosis using FFR in patients with type 2 diabetes.
Methods And Design: This study will be a prospective, non-randomized, multicenter trial performed in Japan. Patients with type 2 diabetes who have intermediate coronary artery stenosis (diameter stenosis <70%) as evaluated by CCTA will be treated with 25mg/day of alogliptin. After 48 weeks' treatment, CCTA will be repeated. The primary endpoint will be changes in FFR, and the secondary endpoint will be the change in plaque volume from baseline to the 48-week follow-up.
Conclusion: This study will be the first multicenter trial to evaluate the effects of alogliptin on coronary atherosclerosis using the newly developed FFR as the primary endpoint, and the findings will clarify the anti-atherogenic effects of alogliptin.
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| http://dx.doi.org/10.1016/j.jjcc.2016.04.014 | DOI Listing |
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