Effects of Linagliptin on Endothelial Function and Global Arginine Bioavailability Ratio in Coronary Artery Disease Patients with Early Diabetes

Abstract

Aims: To investigate the effects of the DPP-4 inhibitor Linagliptin in subjects with coronary artery disease (CAD) and early type 2 diabetes mellitus (T2DM) on a set of cardiovascular surrogate measurements. Materials and Methods: In this randomized, placebo-controlled, double-blind, single-center study, we included subjects with early diabetes (postchallenge diabetes (2h glucose >200mg/dl) or T2DM treated with diet only or on a stable dose of metformin monotherapy, HbA1c<75mmol/mol) and established CAD. Participants were randomized to receive either Linagliptin (5mg) once daily orally or placebo for 12 weeks. The primary outcome was the change in flow mediated dilatation (FMD). Results: We investigated 43 patients with a mean age of 6±8 years. FMD at baseline was 3.5±3.1% in the Linagliptin group vs. 4.0±2.9% in the placebo group. The change in mean FMD in the Linagliptin group (0.4±4.8%) was not significantly different compared to the change in the placebo group (-0.45±3.01%; p=0.486). No significant improvements were seen in the arginine bioavailability ratios (GABR); p=0.6and AOR; p=0.549), body weight, blood pressure and lipid parameters. Of note, HbA1c was significantly reduced in the linagliptin group (-1.5 vs. -0.4; p=0.026). Conclusion: Linagliptin treatment in subjects with CAD and early T2DM did not improve endothelial function or GABR. Disclosure F. Aberer: None. N.J. Tripolt: None. J. Url: None. R. Hödl: None. G. Dimsity: None. F. Aziz: None. R. Riedl: None. F. Hafner: None. D. Strunk: None. T. Stojakovic: None. M. Brodmann: None. H. Sourij: Speaker's Bureau; Self; Boehringer Ingelheim GmbH, Novo Nordisk A/S, Amgen Inc., Sanofi, MSD K.K.. Research Support; Self; AstraZeneca, Boehringer Ingelheim GmbH, MSD K.K., GI Dynamics Inc..