Canagliflozin for Japanese patients with chronic heart failure and type II diabetes

Sezai, Akira; Sekino, Hisakuni; Unosawa, Satoshi; Taoka, Makoto; Osaka, Shunji; Tanaka, Masashi

doi:10.1186/s12933-019-0877-2

Cited by 64 publications

(48 citation statements)

References 28 publications

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“…Thus, instead of biopsy, it would be feasible to use VAT SUVmax as a surrogate marker of VAT inflammation in clinical practice. Recently, several randomized clinical trials have demonstrated that both novel drugs glucagon-like-peptide-1 (GLP-1) receptor agonist and sodium glucose cotransporter 2 inhibitors (SGLT2i) can reduce visceral adiposity thereby attenuating CVD risks [33][34][35]. Considering that the inflamed VAT is a causal mechanism which contributes to the development of CVD, it is conceivable that VAT SUVmax could be employed as a potential surrogate marker of VAT inflammation, thereby evaluating therapeutic effect of both GLP-1 receptor agonist and SGLT2i targeting inflamed VAT and its related CVD risk.…”

Section: Discussionmentioning

confidence: 99%

Association of glucose uptake of visceral fat and acute myocardial infarction: a pilot 18F-FDG PET/CT study

Pahk

Kim

Joung

et al. 2020

Cardiovasc Diabetol

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Background Inflamed visceral adipose tissue (VAT) facilitates chronic inflammation in atherosclerotic lesions thereby leading to increased risk of coronary artery disease (CAD). In this study, we evaluated the glucose uptake of VAT and the carotid artery with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) and their association with CAD, including acute myocardial infarction (AMI). Methods A total of 90 participants were enrolled (32 with AMI, 33 with chronic stable angina; CSA, and 25 control participants) and undertook 18F-FDG PET/CT. VAT glucose uptake was measured by using maximum standardized uptake value (SUVmax) of VAT region. The target-to-background ratio (TBR) of carotid artery was defined as the SUVmax of carotid artery divided by the SUVmax of jugular vein. The SUVmax of spleen, bone-marrow (BM), and high-sensitivity C-reactive protein (hsCRP) were used for the assessment of systemic inflammatory activity. Results VAT SUVmax was highest in participants with AMI, intermediate in participants with CSA, and lowest in control participants. Carotid artery TBR and systemic inflammatory surrogate markers including spleen SUVmax, BM SUVmax, and hsCRP were also higher in the AMI group than in the CSA or control group. Furthermore, VAT SUVmax showed significant positive correlation with carotid artery TBR, spleen SUVmax, BM SUVmax, and hsCRP. In multivariate linear regression and logistic regression analyses, VAT SUVmax was independently associated with carotid artery TBR and AMI. Conclusions Glucose uptake of VAT assessed by 18F-FDG PET/CT was associated with the severity of CAD and synchronized with the carotid artery inflammation in participants with CAD.

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Section: Discussionmentioning

confidence: 99%

Association of glucose uptake of visceral fat and acute myocardial infarction: a pilot 18F-FDG PET/CT study

Pahk

Kim

Joung

et al. 2020

Cardiovasc Diabetol

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“…Intervention for these risk factors and optimal glycemic control are the critical component of diabetes management. A recent study demonstrated that the use of sodium glucose cotransporter 2 inhibitors (SGLT2-is) reduces the risk of major cardiovascular events [51, 52]. In addition, the abnormal platelet activation observed in patients with DM is conducive to the formation of pathological thrombosis and the progression of cardiovascular diseases [53].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome comparison of percutaneous coronary intervention and bypass surgery in diabetic patients with coronary artery disease: a meta-analysis of randomized controlled trials and observational studies

Zhai

Cong

Hou

et al. 2019

Diabetol Metab Syndr

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BackgroundThe optimal revascularization technique in diabetic patients with complex coronary artery disease (CAD), including left main CAD and multivessel coronary disease (MVD), remains controversial. The current study aimed to compare adverse clinical endpoints of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM).MethodsRelevant studies were found from MEDLINE, OVID, Science Direct, Embase and the Cochrane Central database from January 2010 to April 2019. Risk ratio (RR) with 95% confidence interval (CI) was used to express the pooled effect on discontinuous variables. Outcomes evaluated were all-cause mortality, major adverse cardiac/cerebrovascular events (MACCE), cardiac death, myocardial infarction, stroke, and repeat revascularization.ResultsSixteen studies were included (18,224 patients). PCI was associated with the increase risk for MACCE (RR 1.59, 95% CI 1.38–1.85), cardiac death (RR 1.76, 95% CI 1.11–2.80), MI (RR 1.98, 95% CI 1.53–2.57), repeat revascularization (RR 2.61, 95% CI 2.08–3.29). The risks for all-cause mortality (RR 1.23, 95% CI 1.00–1.52) and stroke (RR 0.71, 95% CI 0.48–1.03) were similar between two strategies. Stratified analysis based on studies design and duration of follow-up showed largely similar findings with the overall analyses, except for a significant increased risk of all-cause mortality (RR 1.32, 95% CI 1.04–1.67) in long-term group, and CABG was associated with a higher stroke rate compared to PCI, which are results that were found in RCTs (RR 0.47, 95% CI 0.28–0.79) and mid-term groups (RR 0.39, 95% CI 0.23–0.66).ConclusionsCABG was superior to PCI for diabetic patients with complex CAD (including left main CAD and/or MVD), but might be associated with a higher risk of stroke mid-term follow-up.Number of Protocol registration PROSPERO CRD 42019138505.

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“…However, beneficial effect of SGLT2i has also been suggested in patients with HFpEF: in an echocardiographic study by Soga et al the mitral E/e' ratio, LV-MI, and LAVI were decreased with dapagliflozin treatment among diabetic patients with high prevalence of HFpEF (69%) and HFmrEF (17%), whereas the improvement in LV systolic function and the reduction in BNP levels were minimal [31]. A recent prospective study of diabetic patients with HFpEF demonstrated reductions in E/e' ratio and BNP level, along with improved renal function, decreased fat volumes and reduced oxidative stress [32].…”

Section: Differences In Sglt2i Effects Between Hfref Vs Hfpefmentioning

confidence: 97%

Different effects of SGLT2 inhibitors according to the presence and types of heart failure in type 2 diabetic patients

Hwang

Cho

Park

et al. 2020

Cardiovasc Diabetol

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Background: The effects of sodium-glucose cotransporter 2 inhibitor (SGLT2i) on cardiac function are not fully understood. We investigated the changes in cardiac function in diabetic patients according to the presence and types of heart failure (HF). Methods: We retrospectively identified 202 diabetic patients who underwent echocardiography before, and 6 to 24 months after the initiation of SGLT2i. After propensity score matching with diabetic patients without SGLT2i, the study population (n = 304) were categorized into group 1 (without HF nor SGLT2i; n = 76), group 2 (without HF and received SGLT2i; n = 78), group 3 (with HF but without SGLT2i; n = 76), and group 4 (with HF and received SGLT2i; n = 74). Changes in echocardiographic parameters were compared between these 4 groups, and between HF patients with reduced versus preserved ejection fraction (EF). Results: After a median 13 months of follow-up, HF patients with SGLT2i showed a significant decrease in left ventricular end-diastolic dimension (LV-EDD; from 57.4 mm [50.0-64.9] to 53.0 mm [48.0-60.0]; p < 0.001) and improvement in LV-EF (from 36.1% [25.6-47.5] to 45.0% [34.8-56.3]; p < 0.001). LV mass index and diastolic parameters also showed improvements in HF patients with SGLT2i. The SGLT2i-induced improvements in cardiac function were more prominent in HF patients than those without HF, and in HFrEF patients than HFpEF patients. Conclusions: Use of SGLT2i improved cardiac function in diabetic patients, regardless of the presence of HF. The improvements were more prominent in HF patients, especially in those with HFrEF. These improvements in cardiac function would contribute to the clinical benefit of SGLT2i.

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Canagliflozin for Japanese patients with chronic heart failure and type II diabetes

Cited by 64 publications

References 28 publications

Association of glucose uptake of visceral fat and acute myocardial infarction: a pilot 18F-FDG PET/CT study

Association of glucose uptake of visceral fat and acute myocardial infarction: a pilot 18F-FDG PET/CT study

Clinical outcome comparison of percutaneous coronary intervention and bypass surgery in diabetic patients with coronary artery disease: a meta-analysis of randomized controlled trials and observational studies

Different effects of SGLT2 inhibitors according to the presence and types of heart failure in type 2 diabetic patients

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