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03.10.2018 | Short Communication

Differential effect of concomitant antidiabetic agents on carotid atherosclerosis: a subgroup analysis of the PROLOGUE study

verfasst von: Atsushi Tanaka, Atsushi Kawaguchi, Jun-ichi Oyama, Tomoko Ishizu, Hiroshi Ito, Jun Fukui, Taizo Kondo, Shigetaka Kuroki, Mamoru Nanasato, Yukihito Higashi, Kohei Kaku, Teruo Inoue, Toyoaki Murohara, Koichi Node

Erschienen in: Heart and Vessels | Ausgabe 2/2019

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Abstract

Accumulated evidence shows that some antidiabetic agents attenuate the progression of carotid atherosclerosis assessed as intima-media thickness (IMT). Although some studies have demonstrated an inhibitory effect of dipeptidyl peptidase-4 inhibitors on carotid IMT progression, in the PROLOGUE study sitagliptin failed to slow progression relative to conventional therapy for 24 months. We hypothesized that differences in the concomitant antidiabetic agents between the groups have influenced the progression of carotid IMT. We performed a post hoc analysis of the PROLOGUE study using subgroups stratified by concomitant antidiabetic agents. Although no subgroup with any combination of agents in the overall patients showed a significant difference between sitagliptin group and conventional therapy group in the changes from baseline in mean common carotid artery (CCA)-IMT at 24 months, a significant attenuation of mean CCA-IMT progression was observed in the sitagliptin group relative to conventional therapy group only in three combination subgroups aged < 70 years, namely no thiazolidinedione; no thiazolidinedione or biguanide; and no thiazolidinedione, biguanide or α-glucosidase inhibitor, even after adjustment for multiple confounding factors. In the three subgroups, no significant difference between sitagliptin group and conventional therapy group in the changes from baseline in HbA1c at 24 months was detected. Our data suggest that some concomitant agents, whose prescription frequencies were increased in the conventional therapy group, may have masked the inhibitory effect of sitagliptin on carotid IMT progression in the PROLOGUE study.
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Metadaten
Titel
Differential effect of concomitant antidiabetic agents on carotid atherosclerosis: a subgroup analysis of the PROLOGUE study
verfasst von
Atsushi Tanaka
Atsushi Kawaguchi
Jun-ichi Oyama
Tomoko Ishizu
Hiroshi Ito
Jun Fukui
Taizo Kondo
Shigetaka Kuroki
Mamoru Nanasato
Yukihito Higashi
Kohei Kaku
Teruo Inoue
Toyoaki Murohara
Koichi Node
Publikationsdatum
03.10.2018
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 2/2019
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-018-1275-5

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Erleiden Menschen mit Vorhofflimmern einen ischämischen Schlaganfall, ist dieser weniger schwer, auch sind Infarktgröße und Blutungsrisiko geringer, wenn sie zuvor orale Antikoagulanzien erhalten haben. Die Art der Antikoagulation spielt dabei keine Rolle.

Mehr Cholesterin im Essen = höheres Herzinfarktrisiko

Je mehr Cholesterin man täglich über die Nahrung zu sich nimmt, desto höher ist offenbar das Herzinfarktrisiko – das legt eine Studie mit US-Veteranen zumindest für Männer nahe.

Antikoagulation bei Vorhofflimmern: Sind DOAK noch zu toppen?

Gegen Thromboembolien so wirksam wie ein DOAK, bei zugleich geringerem Blutungsrisiko – werden Faktor-XI-Hemmer als neue Antikoagulanzien dieser Erwartung gerecht? Eine aktuell publizierte Vergleichsstudie gibt darüber Aufschluss.

"Stammzell-Pflaster" gegen geschwächte Herzen: Hoffnung oder Hype?

Eine Nature-Publikation zur Behandlung der Herzinsuffizienz mit von Stammzellen abgeleiteten Herzzellen sorgt in Publikumsmedien für Wirbel. Deren Erkenntnisse sind in der Tat spektakulär – und gleichzeitig vorläufig und ernüchternd. 

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Update Kardiologie

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