title: Effect of sarpogrelate, a selective 5-HT2Areceptor antagonist, on characteristics of coronary artery disease in patients with type 2 diabetes.
abstract: Sarpogrelate, a 5-hydroxytryptamine type 2A antagonist, is a potential antiplatelet agent. We performed a randomized study to evaluate the effect of sarpogrelate on vascular health in Korean patients with diabetes.
  
  
  
  Forty diabetic patients aged 58.6 ± 6.8 years with 10-75% coronary artery stenosis, as assessed by coronary computed tomography angiography, were randomly assigned to sarpogrelate 300 mg/day plus aspirin 100 mg/day (SPG + ASA group) or aspirin 100 mg/day alone (ASA group) for 6 months. The primary endpoint of this study was the change in coronary artery disease including the calcium score (CACS), maximal stenosis, and plaque volume (calcified vs. noncalcified). The secondary endpoints were changes in biochemical parameters related to glucose and lipid metabolism, and in subclinical atherosclerosis assessed by ankle-brachial index and pulse wave velocity.
  
  
  
  After 6-month treatment, there was no significant difference in the changes in CACS, coronary stenosis, ankle-brachial index, and pulse wave velocity, between groups. The total plaque volume decreased from 82.4 ± 14.5 mm3to 74.6 ± 14.4 mm3in the SPG + ASA group, but increased from 64.9 ± 16.0 mm3to 68.6 ± 16.3 mm3in the ASA group (p < 0.05), mainly driven by changes in the noncalcified component (SPG + ASA group 15.6 ± 4.6 mm3to 11.2 ± 3.7 mm3vs. ASA group 21.2 ± 6.2 mm3to 22.8 ± 6.6 mm3, p < 0.01). Serum C-reactive protein levels and homeostasis model assessment of insulin resistance tended to decrease in the SPG + ASA group, but they were not altered in the ASA group.
  
  
  
  The present study demonstrated that sarpogrelate treatment may decrease coronary artery plaque volume, particularly the noncalcified portion, in patients with diabetes.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Dong-Hwa
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Chun
authors.affiliation: Department of Radiology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Jee Hye
authors.initials: JH
authors.lastname: Hur
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Se Hee
authors.initials: SH
authors.lastname: Min
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Jie-Eun
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Tae Jung
authors.initials: TJ
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Hak Chul
authors.initials: HC
authors.lastname: Jang
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Han
authors.affiliation: Department of Radiology, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: Doo Kyoung
authors.initials: DK
authors.lastname: Kang
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea. Electronic address: jinkim@ajou.ac.kr.
authors.forename: Hae Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea. Electronic address: limsoo@snu.ac.kr.
authors.forename: Soo
authors.initials: S
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D058226:Plaque, Atherosclerotic; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D063177:Pulse Wave Analysis; D056910:Republic of Korea; D058830:Serotonin 5-HT2 Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013386:Succinates / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000188:drug therapy
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D010975:Platelet Aggregation Inhibitors; D058830:Serotonin 5-HT2 Receptor Antagonists; D013386:Succinates; C064294:sarpogrelate; D001241:Aspirin
keywords: Coronary artery disease; Coronary plaque; Diabetes mellitus; Sarpogrelate