TY - JOUR
T1 - Glucagon-like Peptide-1 analogues and delipidation of coronary atheroma in statin-treated type 2 diabetic patients with coronary artery disease
T2 - The prespecified sub-analysis of the OPTIMAL randomized clinical trial
AU - Kataoka, Yu
AU - Kitahara, Satoshi
AU - Funabashi, Sayaka
AU - Makino, Hisashi
AU - Matsubara, Masaki
AU - Matsuo, Miki
AU - Omura-Ohata, Yoko
AU - Koezuka, Ryo
AU - Tochiya, Mayu
AU - Tamanaha, Tamiko
AU - Tomita, Tsutomu
AU - Honda-Kohmo, Kyoko
AU - Noguchi, Michio
AU - Murai, Kota
AU - Sawada, Kenichiro
AU - Iwai, Takamasa
AU - Matama, Hideo
AU - Honda, Satoshi
AU - Fujino, Masashi
AU - Nakao, Kazuhiro
AU - Yoneda, Shuichi
AU - Takagi, Kensuke
AU - Otsuka, Fumiyuki
AU - Asaumi, Yasuhide
AU - Hosoda, Kiminori
AU - Nicholls, Stephen J.
AU - Yasuda, Satoshi
AU - Noguchi, Teruo
N1 - Funding Information:
This trial was supported by Japan Agency for Medical Research and Development (grant number: 18ek0210104h0001, tel: +81-3-6870-2200).
Publisher Copyright:
© 2024
PY - 2024/6
Y1 - 2024/6
N2 - Background and aims: Randomized clinical trials have demonstrated the ability of glucagon-like peptide-1 analogues (GLP-1RAs) to reduce atherosclerotic cardiovascular disease events in patients with type 2 diabetes (T2D). How GLP-1RAs modulate diabetic atherosclerosis remains to be determined yet. Methods: The OPTIMAL study was a prospective randomized controlled study to compare the efficacy of 48-week continuous glucose monitoring- and HbA1c-guided glycemic control on near infrared spectroscopty (NIRS)/intravascular ultrasound (IVUS)-derived plaque measures in 94 statin-treated patients with T2D (jRCT1052180152, UMIN000036721). Of these, 78 patients with evaluable serial NIRS/IVUS images were analyzed to compare plaque measures between those treated with (n = 16) and without GLP-1RAs (n = 72). Results: All patients received a statin, and on-treatment LDL-C levels were similar between the groups (66.9 ± 11.6 vs. 68.1 ± 23.2 mg/dL, p = 0.84). Patients receiving GLP-1RAs demonstrated a greater reduction of HbA1c [-1.0 (-1.4 to −0.5) vs. −0.4 (-0.6 to −0.2)%, p = 0.02] and were less likely to demonstrate a glucose level >180 mg/dL [-7.5 (-14.9 to −0.1) vs. 1.1 (-2.0 - 4.2)%, p = 0.04], accompanied by a significant decrease in remnant cholesterol levels [-3.8 (-6.3 to −1.3) vs. −0.1 (-0.8 - 1.1)mg/dL, p = 0.008]. On NIRS/IVUS imaging analysis, the change in percent atheroma volume did not differ between the groups (−0.9 ± 0.25 vs. −0.2 ± 0.2%, p = 0.23). However, GLP-1RA treated patients demonstrated a greater frequency of maxLCBI4mm regression (85.6 ± 0.1 vs. 42.0 ± 0.6%, p = 0.01). Multivariate analysis demonstrated that the GLP-1RA use was independently associated with maxLCBI4mm regression (odds ratio = 4.41, 95%CI = 1.19–16.30, p = 0.02). Conclusions: In statin-treated patients with T2D and CAD, GLP-1RAs produced favourable changes in lipidic plaque materials, consistent with its stabilization.
AB - Background and aims: Randomized clinical trials have demonstrated the ability of glucagon-like peptide-1 analogues (GLP-1RAs) to reduce atherosclerotic cardiovascular disease events in patients with type 2 diabetes (T2D). How GLP-1RAs modulate diabetic atherosclerosis remains to be determined yet. Methods: The OPTIMAL study was a prospective randomized controlled study to compare the efficacy of 48-week continuous glucose monitoring- and HbA1c-guided glycemic control on near infrared spectroscopty (NIRS)/intravascular ultrasound (IVUS)-derived plaque measures in 94 statin-treated patients with T2D (jRCT1052180152, UMIN000036721). Of these, 78 patients with evaluable serial NIRS/IVUS images were analyzed to compare plaque measures between those treated with (n = 16) and without GLP-1RAs (n = 72). Results: All patients received a statin, and on-treatment LDL-C levels were similar between the groups (66.9 ± 11.6 vs. 68.1 ± 23.2 mg/dL, p = 0.84). Patients receiving GLP-1RAs demonstrated a greater reduction of HbA1c [-1.0 (-1.4 to −0.5) vs. −0.4 (-0.6 to −0.2)%, p = 0.02] and were less likely to demonstrate a glucose level >180 mg/dL [-7.5 (-14.9 to −0.1) vs. 1.1 (-2.0 - 4.2)%, p = 0.04], accompanied by a significant decrease in remnant cholesterol levels [-3.8 (-6.3 to −1.3) vs. −0.1 (-0.8 - 1.1)mg/dL, p = 0.008]. On NIRS/IVUS imaging analysis, the change in percent atheroma volume did not differ between the groups (−0.9 ± 0.25 vs. −0.2 ± 0.2%, p = 0.23). However, GLP-1RA treated patients demonstrated a greater frequency of maxLCBI4mm regression (85.6 ± 0.1 vs. 42.0 ± 0.6%, p = 0.01). Multivariate analysis demonstrated that the GLP-1RA use was independently associated with maxLCBI4mm regression (odds ratio = 4.41, 95%CI = 1.19–16.30, p = 0.02). Conclusions: In statin-treated patients with T2D and CAD, GLP-1RAs produced favourable changes in lipidic plaque materials, consistent with its stabilization.
KW - Coronary atherosclerosis
KW - Glucagon-like peptide-1 analogues
KW - Intravascular ultrasound
KW - Lipidic plaque
KW - Near-infrared spectroscopy
KW - Type 2 diabetes mellitus
UR - https://www.scopus.com/pages/publications/85189699474
U2 - 10.1016/j.athplu.2024.03.001
DO - 10.1016/j.athplu.2024.03.001
M3 - Article
C2 - 38617596
AN - SCOPUS:85189699474
SN - 2667-0909
VL - 56
SP - 1
EP - 6
JO - Atherosclerosis Plus
JF - Atherosclerosis Plus
ER -
