Empagliflozin attenuates neointimal hyperplasia after drug-eluting-stent implantation in patients with type 2 diabetes
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ORIGINAL ARTICLE
Empagliflozin attenuates neointimal hyperplasia after drug‑eluting‑stent implantation in patients with type 2 diabetes Takehiro Hashikata1 · Masayasu Ikutomi1 · Takahiro Jimba1 · Akito Shindo1 · Nobutaka Kakuda2 · Susumu Katsushika2 · Masaaki Yokoyama3 · Mikio Kishi1 · Takahiro Sato1 · Masashiro Matsushita1 · Satoshi Ohnishi1 · Masao Yamasaki1 Received: 10 February 2020 / Accepted: 1 May 2020 © Springer Japan KK, part of Springer Nature 2020
Abstract The effects of empagliflozin, a sodium-glucose co-transporter 2 inhibitor, on neointimal response after drug-eluting-stent (DES) implantation remains unknown. Insufficiently controlled diabetes patients with coronary artery disease planned for DES stenting were consecutively enrolled. The patients were assigned to receive empagliflozin in addition to standard therapy or intensive therapy using other glucose-lowering drugs (oGLD). The primary endpoint was thickness of neointimal hyperplasia (NIH) 12 months after stenting assessed by optical coherence tomography (OCT). A total of 28 patients were analyzed (n = 15 in the empagliflozin group, n = 13 in the oGLD group). The levels of glucose profile were not significantly different between both groups at follow-up [HbA1c; 7.2 ± 0.8 vs 7.3 ± 0.9%, p = 0.46]. In OCT analysis, neointima was significantly less in the empagliflozin group than the oGLD group [mean NIH thickness: 137 ± 32 vs 168 ± 39 μm, p = 0.02]. Changes of systolic and diastolic blood pressure (BP), changes of body mass index, and changes of hematocrit after additional treatment were significantly associated with NIH attenuation, whereas no correlation was observed in changes in blood glucose parameters. Multivariate logistic regression analysis revealed that changes in systolic BP was the strongest predictor for NIH attenuation, followed by changes in diastolic BP. In patients with type 2 diabetes, standard plus empagliflozin attenuated neointimal progression as compared with intensive standard therapy after DES implantation. Our data possibly support a beneficial effect of empagliflozin in type 2 diabetes required for coronary revascularization therapy. Keywords Empagliflozin · Diabetes mellitus · Drug-eluting stent · Optical coherence tomography · Neointimal hyperplasia
Introduction Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have been used as important new agents for the treatment of patients with type 2 diabetes. A large clinical study, the Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00380-020-01621-0) contains supplementary material, which is available to authorized users. * Takehiro Hashikata [email protected]‑u.ac.jp 1
Department of Cardiology, NTT Medical Center Tokyo, 5‑9‑22 Higashigotanda, Shinagawa, Tokyo 141‑0022, Japan
2
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
3
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
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