Add-on vildagliptin improves outcomes in patients with diabetes, CAD

Patients with type 2 diabetes mellitus (T2DM) and symptomatic coronary artery disease (CAD) treated with metformin fare better with the addition of vildagliptin versus glimepiride, as the former is associated with better glycaemic control and lipid profile, according to a study.

A total of 80 patients with uncontrolled T2DM on metformin (1,000 mg/day) and symptomatic CAD were randomized to receive adjunctive treatment with vildagliptin 50 mg/day or glimepiride 4 mg/day.

All participants had their blood samples taken at baseline and 3 months after the intervention for biochemical analysis of HbA1c percentage, interleukin (IL)-1β, adiponectin, high-sensitivity C-reactive protein (hsCRP), and lipid profile. Atherogenic index (AI) and coronary risk index (CRI) were also assessed.

At month 3, outcomes were more favourable with vildagliptin than with glimepiride. Specifically, patients who received the former had markedly lower body mass index (mean, 28.73 vs 30.55 kg/m²; p=0.02) and HbA1c (mean, 6.05 vs 7.06; p<0.0001). They also had decreased concentrations of inflammatory markers, including hsCRP (mean, 0.96 vs 1.72 mg/L; p<0.0001), IL-1β (mean, 34.95 vs 45.13 pg/mL; p<0.0001).

Furthermore, compared with glimepiride, vildagliptin substantially improved the lipid profile and the concentrations of protective markers. The corresponding mean values at week 3 were 136 vs 169 mg/dL for total cholesterol (p<0.0001), 116 vs 146 mg/dL for triglycerides (p=0.005), 2.47 percent vs 3.65 percent for CRI (p<0.0001), 4.42 vs 2.52 μg/mL for adiponectin (p<0.0001), and 61 vs 48 mg/dL for high-density lipoprotein cholesterol  (p=0.003).