Dapagliflozin improves endothelial function, microvascular reactivity in type 2 diabetes
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Patients with diabetes experienced significant improvement in endothelial function and microvascular reactivity while taking daily dapagliflozin, according to research presented at the virtual Heart in Diabetes Conference.
“Type 2 diabetes mellitus is a major risk factor for the development of cardiovascular disease and the development of atherosclerosis,” Oleksii Korzh, MD, DrMedSci, academic researcher at Kharkiv Medical Academy of Postgraduate Education, Ukraine, said during the presentation. “The progression of insulin resistance in type 2 diabetes accelerates the development of endothelial dysfunction, which has been shown to be associated with increased cardiovascular risk. In part, endothelial function is considered the pathophysiological starting point in the initiation and progression of vascular disease.
“Previous studies have shown that an oral hypoglycemic agent may play a role in improving endothelial function beyond their glycemic control,” Korzh said in his presentation. “SGLT2 inhibitors represent a relatively new class of oral antidiabetic agents, with promising cardiovascular benefits. Our study was designed to evaluate the effect of SGLT2 inhibitor dapagliflozin on endothelial function and microvascular activity in patients with type 2 diabetes mellitus.”
Investigators enrolled 35 patients with type 2 diabetes and 35 healthy controls and compared baseline biomarkers, vascular health and microcirculation between groups at baseline and at 12 weeks of daily treatment of 10 mg dapagliflozin (Farxiga, AstraZeneca).
Endothelial function and vascular health were measured with flow-medicated dilation and nitroglycerin-induced dilatation of the brachial artery and carotid artery intima-media thickness in addition to biomarkers related to lipid and glucose metabolism and high-sensitivity C-reactive protein for inflammation.
Researchers observed that during the study period, patients who took daily dapagliflozin experienced an 11.9% increase in flow-medicated dilation but no change in nitroglycerin-induced dilatation.
According to the study, maximum intima-media thickness at the right and left bulb and internal carotid areas in both carotid arteries decreased from baseline among patients in the dapagliflozin group.
Moreover, researchers observed negative associations between change in HbA1c and flow-mediated dilation (r = –0.31; P = .016) and change in HbA1c and microvascular reactivity (r = –0.281; P = .021).
“We suggest that in addition to its glucose-lowering effect, the improvements in endothelial function from dapagliflozin treatment may contribute to its beneficial impact in cardiovascular morbidity and mortality,” Korzh said during the presentation. “The results are consistent with other recent published experimental animal and human studies describing the effects of this new drug or vascular function evaluated using different techniques. All of these results make SGLT2 inhibition with dapagliflozin an attractive antidiabetic therapeutic target with additional cardiovascular benefits.”
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Korzh O, et al. Abstract 35. Presented at: Heart in Diabetes CME Conference; Aug. 21-24, 2020 (virtual meeting).
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