Cited by 165Diabetes Treatment and ManagementHeart Failure Treatment and ManagementCardiovascular Function and Risk Factors

Effects of Vildagliptin on Ventricular Function in Patients With Type 2 Diabetes Mellitus and Heart Failure

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McMurray, John J.V., Ponikowski, Piotr, Bolli, Geremia B., Lukashevich, Valentina, Kozlovski, Plamen, Kothny, Wolfgang, Lewsey, James D., Krum, Henry·2018·JACC: Heart Failure

Abstract

Objectives This study sought to examine the safety of the dipeptidyl peptidase-4 inhibitor, vildagliptin, in patients with heart failure and reduced ejection fraction.Background Many patients with type 2 diabetes mellitus have heart failure and it is important to know about the safety of new treatments for diabetes in these individuals.Methods Patients 18 to 85 years of age with type 2 diabetes and heart failure (New York Heart Association functional class I to III and left ventricular ejection fraction [LVEF] <0.40) were randomized to 52 weeks treatment with vildagliptin 50 mg twice daily (50 mg once daily if treated with a sulfonylurea) or matching placebo. The primary endpoint was between-treatment change from baseline in echocardiographic LVEF using a noninferiority margin of -3.5%.Results A total of 254 patients were randomly assigned to vildagliptin (n = 128) or placebo (n = 126). Baseline LVEF was 30.6 ± 6.8% in the vildagliptin group and 29.6 ± 7.7% in the placebo group. The adjusted mean change in LVEF was 4.95 ± 1.25% in vildagliptin treated patients and 4.33 ± 1.23% in placebo treated patients, a difference of 0.62 (95% confidence interval [CI]: -2.21 to 3.44; p = 0.667). This difference met the predefined noninferiority margin of -3.5%. Left ventricular end-diastolic and end-systolic volumes increased more in the vildagliptin group by 17.1 ml (95% CI: 4.6 to 29.5 ml; p = 0.007) and 9.4 ml (95% CI: -0.49 to 19.4 ml; p = 0.062), respectively. Decrease in hemoglobin A 1c from baseline to 16 weeks, the main secondary endpoint, was greater in the vildagliptin group: -0.62% (95% CI: -0.93 to -0.30%; p < 0.001; -6.8 mmol/mol; 95% CI: -10.2 to -3.3 mmol/mol).Conclusions Compared with placebo, vildagliptin had no major effect on LVEF but did lead to an increase in left ventricular volumes, the cause and clinical significance of which is unknown. More evidence is needed regarding the safety of dipeptidyl peptidase-4 inhibitors in patients with heart failure and left ventricular systolic dysfunction. (Effect of Vildagliptin on Left Ventricular Function in Patients With Type 2 Diabetes and Congestive Heart Failure; NCT00894868).

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  1. MacDonald MR, Petrie MC, Hawkins et al. Diabetes, left ventricular systolic dysfunction, and chronic heart failure. Eur Heart J 2008; 29: 1224-40.
  2. MacDonald MR, Petrie MC, Varyani F, et al; CHARM Investigators.. Impact of diabetes on outcomes in patients with low and preserved ejection fraction heart failure: an analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme. Eur Heart J 2008; 29: 1377-85.
  3. Dauriz M, Targher G, Laroche C, et al; ESC-HFA Heart Failure Long-Term Registry.. Association Between Diabetes and 1-Year Adverse Clinical Outcomes in a Multinational Cohort of Ambulatory Patients With Chronic Heart Failure: Results From the ESC-HFA Heart Failure Long-Term Registry. Diabetes Care 2017; 40: 671-678.
  4. Suskin N, McKelvie RS, Burns RJ, et al. Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure. Eur Heart J 2000; 21: 1368-75.
  5. McMurray JJ, Gerstein HC, Holman RR, Pfeffer MA. Heart failure: a cardiovascular outcome in diabetes that can no longer be ignored. Lancet Diabetes Endocrinol. 2014 Oct;2(10):843-51.
  6. Crowley MJ, Diamantidis CJ, McDuffie JR, et al. Clinical Outcomes of Metformin Use in Populations With Chronic Kidney Disease, Congestive Heart Failure, or Chronic Liver Disease: A Systematic Review. Ann Intern Med 2017; 166: 191-200.
  7. Fitchett DH, Udell JA, Inzucchi SE. Heart failure outcomes in clinical trials of glucose- lowering agents in patients with diabetes. Eur J Heart Fail 2017; 19: 43-53.
  8. Komajda M, McMurray JJ, Beck-Nielsen H, et al. Heart failure events with rosiglitazone in type 2 diabetes: data from the RECORD clinical trial. Eur Heart J 2010; 31: 824-31.
  9. Hernandez AV, Usmani A, Rajamanickam A, et al. Thiazolidinediones and risk of heart failure in patients with or at high risk of type 2 diabetes mellitus: a meta-analysis and meta-regression analysis of placebo-controlled randomized clinical trials. Am J Cardiovasc Drugs 2011; 11: 115-28.
  10. Giles TD, Elkayam U, Bhattacharya M, et al. Comparison of pioglitazone vs glyburide in early heart failure: insights from a randomized controlled study of patients with type 2 diabetes and mild cardiac disease. Congest Heart Fail 2010; 16: 111-7.
  11. Dargie HJ, Hildebrandt PR, Riegger GA, et al. A randomized, placebo-controlled trial assessing the effects of rosiglitazone on echocardiographic function and cardiac status in type 2 diabetic patients with New York Heart Association Functional Class I or II Heart Failure. J Am Coll Cardiol 2007; 49: 1696-704.
  12. Scirica BM, Bhatt DL, Braunwald E, et al; SAVOR-TIMI 53 Steering Committee and Investigators.. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med 2013; 369: 1317-26.
  13. White WB, Cannon CP, Heller SR, et al; EXAMINE Investigators.. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med 2013; 369: 1327-35.
  14. Green JB, Bethel MA, Armstrong PW, et al; TECOS Study Group. Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2015; 373: 232-42.
  15. McGuire DK, Van de Werf F, Armstrong PW, et al; Trial Evaluating Cardiovascular Outcomes With Sitagliptin (TECOS) Study Group.. Association Between Sitagliptin Use and Heart Failure Hospitalization and Related Outcomes in Type 2 Diabetes Mellitus: Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol 2016; 1: 126-35.
  16. Scirica BM, Braunwald E, Raz I, et al; SAVOR-TIMI 53 Steering Committee and Investigators.. Heart Failure, Saxagliptin, and Diabetes Mellitus: Observations from the SAVOR-TIMI 53 Randomized Trial. Circulation 2015; 132: e198.
  17. Zannad F, Cannon CP, Cushman WC, et al; EXAMINE Investigators.. Heart failure and mortality outcomes in patients with type 2 diabetes taking alogliptin versus placebo in EXAMINE: a multicentre, randomised, double-blind trial. Lancet 2015; 385: 2067-76.
  18. Cai L, Cai Y, Lu ZJ, et al. The efficacy and safety of vildagliptin in patients with type 2 diabetes: a meta-analysis of randomized clinical trials. J Clin Pharm Ther 2012; 37: 386-98.
  19. Schiller NB, Acquatella H, Ports TA, et al. Left ventricular volume from paired biplane two-dimensional echocardiography. Circulation 1979; 60: 547-55..
  20. Konstam MA, Udelson JE, Anand IS, Cohn JN. Ventricular remodeling in heart failure: a credible surrogate endpoint. J Card Fail 2003; 9: 350-3.
  21. Cohn JN, Ferrari R, Sharpe N. Cardiac remodeling--concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. Behalf of an International Forum on Cardiac Remodeling. J Am Coll Cardiol 2000; 35: 569-82.
  22. Marso SP, Daniels GH, Brown-Frandsen K, et al; LEADER Steering Committee.; LEADER Trial Investigators.. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016; 375: 311-22.
  23. Pfeffer MA, Claggett B, Diaz R, et al; ELIXA Investigators.. Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome. N Engl J Med 2015; 373: 2247- 57.
  24. Marso SP, Bain SC, Consoli A, et al; SUSTAIN-6 Investigators.. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016; 375: 1834-1844.
  25. Jorsal A, Kistorp C, Holmager P, et al. Effect of liraglutide, a glucagon-like peptide-1 analogue, on left ventricular function in stable chronic heart failure patients with and without diabetes (LIVE)-a multicentre, double-blind, randomised, placebo-controlled trial. Eur J Heart Fail 2017; 19: 69-77.
  26. Margulies KB, Hernandez AF, Redfield MM, et al; NHLBI Heart Failure Clinical Research Network.. Effects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial. JAM. 2016; 316: 500-8.
  27. Inthachai T, Lekawanvijit S, Kumfu S, Apaijai N, Pongkan W, Chattipakorn SC, Chattipakorn N. Dipeptidyl peptidase-4 inhibitor improves cardiac function by attenuating adverse cardiac remodelling in rats with chronic myocardial infarction. Exp Physiol. 2015;100:667-79.
  28. Connelly KA, Zhang Y, Advani A, Advani SL, Thai K, Yuen DA, Gilbert RE. DPP-4 inhibition attenuates cardiac dysfunction and adverse remodeling following myocardial infarction in rats with experimental diabetes. Cardiovasc Ther. 2013;31:259-67.
  29. Yin M, Silljé HH, Meissner M, van Gilst WH, de Boer RA. Early and late effects of the DPP-4 inhibitor vildagliptin in a rat model of post-myocardial infarction heart failure. Cardiovasc Diabetol. 2011;10:85.

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Authors
McMurray, J. J. V., Ponikowski, P., Bolli, G. B., Lukashevich, V., Kozlovski, P., Kothny, W., Lewsey, J. D., & Krum, H.
Affiliations
  • University of Glasgow (GB)
  • Wroclaw Medical University (PL)
  • University of Perugia (IT)
  • Novartis (United States) (US)
  • Novartis (Switzerland) (CH)
Corresponding author
McMurray, John J.V.
Venue
JACC: Heart Failure
Publisher
Elsevier BV
Published
2018-01
Volume
6
Issue
1
Pages
8-17
ISSN
2213-1779 (ISSN-L)
OpenAlex
W2752749262
Cited by
165
References
31
Citations by year
2026: 4 · 2025: 6 · 2024: 7 · 2023: 21 · 2022: 22 · 2021: 17 · 2020: 34 · 2019: 25 · 2018: 25 · 2017: 3 · 2015: 1
FWCI
18.79
Type
journal article
Language
en
Open access
Locations
  • JACC Heart Failure (publishedVersion)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
vildagliptin, DPP-4 inhibitors, type 2 diabetes, heart failure with reduced ejection fraction, left ventricular ejection fraction, ventricular function, non-inferiority, glycemic control, HbA1c, left ventricular end-diastolic volume, left ventricular end-systolic volume, drug safety
MeSH terms
Vildagliptin, Adolescent, Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Dose-Response Relationship, Drug, Double-Blind Method, Echocardiography, Female, Follow-Up Studies, Heart Failure, Heart Ventricles, Humans, Hypoglycemic Agents, Male, Middle Aged, Prospective Studies, Stroke Volume, Systole, Ventricular Function, Left, Young Adult

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