Extra-Glycemic Effects May Explain Different CV Outcomes With Dapagliflozin, Vildagliptin

vitals chart and stethoscope
vitals chart and stethoscope
Dapaglifozin and vildagliptin impact cardio-metabolic processes differently.

The following article is part of conference coverage from the 2018 AHA Scientific Sessions in Chicago, Illinois.The Cardiology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in cardiology. Check back for the latest news from AHA 2018.

CHICAGO — The sodium-glucose cotransporter 2 inhibitor, dapagliflozin, and the dipeptidyl peptidase-4 inhibitor, vildagliptin, differentially affect hemodynamic and inflammatory markers in patients with type 2 diabetes (T2D) and coronary artery disease (CAD), and this variation may lead to different cardiovascular outcomes. A study examining these different cardio-metabolic effects was presented at the American Heart Association Scientific Sessions 2018, held November 10–12, in Chicago, Illinois.

Researchers randomly assigned 44 patients with T2D and established CAD into either the dapagliflozin treatment arm (n=21) or the vildagliptin treatment arm (n=23). Anthropometric measurements, glycemic index, lipid profile, renal function, hemoglobin, tumor necrotic factor, and interleukin-10 were measured at baseline and after 6 months of treatment.

The study population was 52% male and had a mean age of 63 years. There were no significant differences between the 2 study arms at baseline. In the timespan of 6 months, the dapagliflozin treatment arm experienced significant body weight reductions, lower body mass index scores, lower systolic blood pressure, and an increase in levels of hemoglobin (P <.05).

When compared to the vildagliptin treatment arm, the dapagliflozin treatment arm had significantly improved changes in body weight, body mass index, hemoglobin, high-sensitive troponin T, and interleukin-10 (P <.05).

No patients reported serious adverse events, but 1 patient in the dapagliflozin treatment arm did develop a non-fatal myocardial infarction.

The researchers concluded that these inhibitors, dapagliflozin and vildagliptin, impact cardio-metabolic processed differently and “[t]hese extra-glycemic effects may contribute to different [cardiovascular] outcomes.”

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Phrommintikul A, Wongcharoen W, Gunaparn S, et al. Dapagliflozin exerts better favorable cardio-metabolic effects than vildagliptin in diabetic patients with coronary artery disease: a randomized study. Abstract presentation at: 2018 AHA Scientific Sessions; November 10-12, 2018; Chicago, IL. Abstract 1004.