may contribute to the observed cardiac benefits (7,10,11,23). Small increases from baseline in median galectin-3 levels were observed with canagliflozin relative to placebo at 26 weeks (6.6 95 CI:.7.6; nominal p .01) and 52 weeks (5.1 95 CI:.0.3; nominal p .01 by 104 weeks, the difference in galectin-3 was still. Marks, Antoinette Moran, Henry Rodriguez, William Russell, Darrell. NT-proBNP was measured on the cobas e601 immunoanalyzer using the proBNP II electrochemiluminescent immunoassay (Roche Diagnostics, Indianapolis, Indiana with interassay coefficients of variation (CV).5 at 137.2 pg/ml (low-quality control concentration) and.3 at 4,830 pg/ml (high-quality control concentration). Considering the correlation between baseline and 104-week concentrations of hsTnI ( Online Figure 1B a lower slope from baseline to final measurement was observed in those treated with canagliflozin. Of those taking diuretic agents, the majority took thiazides (29.2 in the placebo arm and.9 in the canagliflozin arm whereas loop diuretic agents (4.6 and.6) or mineralocorticoid receptor antagonists (0.5 and.1) were less commonly used. Raitakari and Katja Pahkala Diabetes Care 2018 Aug; dc180869. Treatment with sglt2 inhibitors has been shown to increase levels of ketone bodies, which may be a more favorable energetic substrate for the heart compared with glucose or fatty acids (5,6). Table 1 Baseline Demographic and Disease Characteristics Among Patients With Biomarker Assessments Biomarker changes Table 2 summarizes the observed changes in serum NT-proBNP, hsTnI, sST2, galectin-3, eGFR, and hematocrit at all time points.
During the course of the study, no changes in electrocardiographic parameters, such as PR interval, QRS interval, QT/QTc, or RR intervals, were noted between treatment groups (data not shown). Ix, Luc Djousse, Rodrigo. Differences in the concentrations of NT-proBNP and hsTnI between placebo- and canagliflozin-treated patients were relatively modest.
Riddell and for the T1D Exchange Mini-Dose Glucagon Exercise Study Group Diabetes Care 2018 May; dc180051. Dunger, on behalf of the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) Study Group Diabetes Care 2018 Jul; dc181125. Also, exclusion of patients with eGFR 50 ml/min/1.73 m2 might render our data less generalizable to those with worse renal function; this exclusion criterion was due to use of metformin in an older patient population. Briefly, eligible patients were adults with T2DM who were 55 to 80 years of age, had glycosylated hemoglobin.0 and 10.0 and estimated glomerular filtration rate (eGFR) 50 ml/min/1.73 m2, and were either not on any antihyperglycemic agent or were on a stable regimen of monotherapy. Diabetes Care 2018 Aug; dc180567. Oram and the Type 1 Diabetes TrialNet Study Group Diabetes Care 2018 Jul; dc180087. Diabetes Care 2018 Jul; dc180344.
Lastly, we lack data on other novel biomarkers with prognostic value such as mid-regional pro-adrenomedullin or growth differentiation factor-15. Table 2 Summary of Changes in Serum Concentrations of Cardiovascular Biomarkers, eGFR, and Hematocrit From a baseline median of approximately.3 pg/ml, serum hsTnI also gradually increased with placebo at each time point, but was reduced or unchanged with canagliflozin over 104 weeks ( Figure 1B ). Our results represent the first larger-scale, placebo-controlled data regarding cardiac biomarkers in patients treated with sglt2 inhibition. Central Illustration Proposed Mechanisms of Benefit of Canagliflozin and Effect on Cardiac Biomarkers Through its beneficial effects on the heart, canagliflozin prevented a rise in N-terminal proB-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (hsTnI). Indeed, modest reductions in eGFR paralleled the increase in galectin-3, and there was a correlation between change in galectin-3 and change in eGFR over time: thus, change in renal function may account for the declining between-group difference across time points. Add to Selected an Ethics in Decision Making Citations Open Access Electroacupuncture for Painful Diabetic Peripheral Neuropathy: A Multicenter, Randomized, Assessor-Blinded, Controlled Trial Kyung-Min Shin, Seunghoon Lee, Eun Yong Lee, Cheol-Hong Kim, Jung Won Kang, Cham Kyul Lee, Bok-Nam Seo, Ae-Ran Kim, So-Young Jung, Ojin Kwon and Sun-Mi Choi Diabetes. Read, Merel van Diepen, Helen. Appendix For supplemental figures and table, please see the online version of this article. Chiesa, Jane Armitage, Denis Daneman, Kim. Add to Selected Citations, you have accessRestricted Access, glycemic Variation and Cardiovascular Risk in the Veterans Affairs Diabetes Trial.