The DPP-4 inhibitor sitagliptin and endothelial function in patients with acute coronary syndromes and newly detected glucose perturbations: A report from the BEGAMI study.
OBJECTIVE
Compromised endothelial function contributes to poor prognosis in patients with coronary artery disease and type 2 diabetes. Incretin-based therapy may exert beneficial cardiovascular effects beyond glucose lowering. We tested whether sitagliptin improves endothelial function.


METHODS
In the double-blind BEta-cell function in patients with Glucose Abnormalities and Acute Myocardial Infarction (BEGAMI) trial, acute coronary syndrome (ACS)-patients with newly detected impaired glucose tolerance (IGT) or type 2 diabetes mellitus (T2DM) were randomised to sitagliptin 100 mg (n = 31) or placebo (n = 33) during 12 weeks. Endothelial function was studied as reactive hyperaemia index (RHI).


RESULTS
At baseline, the RHI was slightly compromised in both groups (sitagliptin 1.67; Q1;Q3: 1.46;2.17 vs placebo 1.61; 1.44;1.96; ns). The RHI did not change during the study period and was 1.57 (1.40;2.36) in the sitagliptin and 1.60 (1.46;1.81; ns) in the placebo group after treatment.


CONCLUSIONS
Sitagliptin did not improve endothelial function in patients with ACS and newly detected glucose perturbations.
Cardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden Research Unit, Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden camilla.hage@karolinska.se.
Camilla
C
Hage
Endocrine and Diabetes Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Kerstin
K
Brismar
Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
Pia
P
Lundman
Cardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Anna
A
Norhammar
Cardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Lars
L
Rydén
Cardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden Research Unit, Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
Linda
L
Mellbin
Acute coronary syndrome; endothelial function; glucose; glucose perturbations; sitagliptin