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Background: Type 2 Diabetes (T2D) has profound detrimental effects on the macro and micro vasculature, which accounts for a significant portion of the disease impact on cardiovascular (CV) morbidity/mortality. Dapagliflozin (DAPA), an inhibitor of sodium glucose co-transporter 2, has been shown to reduce glycemia and blood pressure in patients with T2D. However, information is scant on the impact of DAPA on arterial stiffness in T2D. We hypothesized that DAPA has a favorable effect on arterial stiffness in patients with T2D.
Methods: A Prospective, randomized (∼2:1), double-blind, parallel-group design trial comparing DAPA 10 mg daily vs Glimepiride 4 mg daily was conducted on 20 T2D patients receiving Metformin as a background therapy. Patients were followed for 16 weeks. Carotid-femoral pulse wave velocity (cfPWV) —a measurement of arterial stiffness— was estimated non-invasively using the Sphygmocor CPV System.
Results: Patients on the DAPA group exhibited a significant decreasing trend in cfPWV across visits (p<0.01), as well as a significant reduction from baseline to week 16 (-1.2 m/s, p=0.02), compared to the Glimepiride group. Between group difference in change from baseline was -1.4 m/s, p<0.01, favoring the DAPA group. Systolic blood pressure and pulse pressure were reduced in the DAPA group but not with Glimepiride.
Conclusions: Our findings support the hypothesis that DAPA has a favorable effect on arterial stiffness in patients with T2D. These findings appear to be independent of glucose control and sodium excretion. Thus, DAPA may have an effect on the elastic structure of the vasculature and/or endothelial function and may provide a simplified therapeutic strategy for the reduction, and perhaps prevention, of the onset and progression of T2D-induced vascular damage and related CV risk.
Moderated Poster Contributions
Vascular Medicine Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 1:15 p.m.-1:25 p.m.
Session Title: Uncovering the Intricacies of Vascular Function
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1228M-09
- 2017 American College of Cardiology Foundation