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Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction

Background: The management of acute myocardial infarction (AMI) presents several challenges in patients with diabetes, among them the higher rate of recurrent thrombotic events, hyperglycemia and risk of subsequent heart failure (HF). The objective of our study was to evaluate effects of DPP-4 inhib...

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Autores principales: Genestreti, Paulo R. Rizzo, Furtado, Remo H. M., Salsoso, Rocio, Dalçóquio, Talia F., Franci, Andre, Menezes, Fernando R., Caporrino, Cesar, Ferrari, Aline G., Nakashima, Carlos A. K., Scanavini Filho, Marco A., Lima, Felipe G., Giraldez, Roberto R. C. V., Baracioli, Luciano M., Nicolau, Jose C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571017/
https://www.ncbi.nlm.nih.gov/pubmed/36233642
http://dx.doi.org/10.3390/jcm11195776
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author Genestreti, Paulo R. Rizzo
Furtado, Remo H. M.
Salsoso, Rocio
Dalçóquio, Talia F.
Franci, Andre
Menezes, Fernando R.
Caporrino, Cesar
Ferrari, Aline G.
Nakashima, Carlos A. K.
Scanavini Filho, Marco A.
Lima, Felipe G.
Giraldez, Roberto R. C. V.
Baracioli, Luciano M.
Nicolau, Jose C.
author_facet Genestreti, Paulo R. Rizzo
Furtado, Remo H. M.
Salsoso, Rocio
Dalçóquio, Talia F.
Franci, Andre
Menezes, Fernando R.
Caporrino, Cesar
Ferrari, Aline G.
Nakashima, Carlos A. K.
Scanavini Filho, Marco A.
Lima, Felipe G.
Giraldez, Roberto R. C. V.
Baracioli, Luciano M.
Nicolau, Jose C.
author_sort Genestreti, Paulo R. Rizzo
collection PubMed
description Background: The management of acute myocardial infarction (AMI) presents several challenges in patients with diabetes, among them the higher rate of recurrent thrombotic events, hyperglycemia and risk of subsequent heart failure (HF). The objective of our study was to evaluate effects of DPP-4 inhibitors (DPP-4i) on platelet reactivity (main objective) and cardiac risk markers. Methods: We performed a single-center double-blind randomized trial. A total of 70 patients with type 2 diabetes (T2DM) with AMI Killip ≤2 on dual-antiplatelet therapy (aspirin plus clopidogrel) were randomized to receive sitagliptin 100 mg or saxagliptin 5 mg daily or matching placebo. Platelet reactivity was assessed at baseline, 4 days (primary endpoint) and 30 days (secondary endpoint) after randomization, using VerifyNow Aspirin™ assay, expressed as aspirin reaction units (ARUs); B-type natriuretic peptide (BNP) in pg/mL was assessed at baseline and 30 days after (secondary endpoint). Results: Mean age was 62.6 ± 8.8 years, 45 (64.3%) male, and 52 (74.3%) of patients presented with ST-segment elevation MI. For primary endpoint, there were no differences in mean platelet reactivity (p = 0.51) between the DPP-4i (8.00 {−65.00; 63.00}) and placebo (−14.00 {−77.00; 52.00}) groups, as well in mean BNP levels (p = 0.14) between DPP-4i (−36.00 {−110.00; 15.00}) and placebo (−13.00 {−50.00; 27.00}). There was no difference between groups in cardiac adverse events. Conclusions: DPP4 inhibitor did not reduce platelet aggregation among patients with type 2 diabetes hospitalized with AMI. Moreover, the use of DPP-4i did not show an increase in BNP levels or in the incidence of cardiac adverse events. These findings suggests that DPP-4i could be an option for management of T2DM patients with acute MI.
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spelling pubmed-95710172022-10-17 Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction Genestreti, Paulo R. Rizzo Furtado, Remo H. M. Salsoso, Rocio Dalçóquio, Talia F. Franci, Andre Menezes, Fernando R. Caporrino, Cesar Ferrari, Aline G. Nakashima, Carlos A. K. Scanavini Filho, Marco A. Lima, Felipe G. Giraldez, Roberto R. C. V. Baracioli, Luciano M. Nicolau, Jose C. J Clin Med Article Background: The management of acute myocardial infarction (AMI) presents several challenges in patients with diabetes, among them the higher rate of recurrent thrombotic events, hyperglycemia and risk of subsequent heart failure (HF). The objective of our study was to evaluate effects of DPP-4 inhibitors (DPP-4i) on platelet reactivity (main objective) and cardiac risk markers. Methods: We performed a single-center double-blind randomized trial. A total of 70 patients with type 2 diabetes (T2DM) with AMI Killip ≤2 on dual-antiplatelet therapy (aspirin plus clopidogrel) were randomized to receive sitagliptin 100 mg or saxagliptin 5 mg daily or matching placebo. Platelet reactivity was assessed at baseline, 4 days (primary endpoint) and 30 days (secondary endpoint) after randomization, using VerifyNow Aspirin™ assay, expressed as aspirin reaction units (ARUs); B-type natriuretic peptide (BNP) in pg/mL was assessed at baseline and 30 days after (secondary endpoint). Results: Mean age was 62.6 ± 8.8 years, 45 (64.3%) male, and 52 (74.3%) of patients presented with ST-segment elevation MI. For primary endpoint, there were no differences in mean platelet reactivity (p = 0.51) between the DPP-4i (8.00 {−65.00; 63.00}) and placebo (−14.00 {−77.00; 52.00}) groups, as well in mean BNP levels (p = 0.14) between DPP-4i (−36.00 {−110.00; 15.00}) and placebo (−13.00 {−50.00; 27.00}). There was no difference between groups in cardiac adverse events. Conclusions: DPP4 inhibitor did not reduce platelet aggregation among patients with type 2 diabetes hospitalized with AMI. Moreover, the use of DPP-4i did not show an increase in BNP levels or in the incidence of cardiac adverse events. These findings suggests that DPP-4i could be an option for management of T2DM patients with acute MI. MDPI 2022-09-29 /pmc/articles/PMC9571017/ /pubmed/36233642 http://dx.doi.org/10.3390/jcm11195776 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Genestreti, Paulo R. Rizzo
Furtado, Remo H. M.
Salsoso, Rocio
Dalçóquio, Talia F.
Franci, Andre
Menezes, Fernando R.
Caporrino, Cesar
Ferrari, Aline G.
Nakashima, Carlos A. K.
Scanavini Filho, Marco A.
Lima, Felipe G.
Giraldez, Roberto R. C. V.
Baracioli, Luciano M.
Nicolau, Jose C.
Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction
title Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction
title_full Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction
title_fullStr Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction
title_full_unstemmed Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction
title_short Effects of DPP4 Inhibitor in Platelet Reactivity and Other Cardiac Risk Markers in Patients with Type 2 Diabetes and Acute Myocardial Infarction
title_sort effects of dpp4 inhibitor in platelet reactivity and other cardiac risk markers in patients with type 2 diabetes and acute myocardial infarction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571017/
https://www.ncbi.nlm.nih.gov/pubmed/36233642
http://dx.doi.org/10.3390/jcm11195776
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