Effects of canagliflozin on cardiovascular biomarkers in older adults with type 2 diabetes

Januzzi, J. L., Butler, J., Jarolim, P., Sattar, N. , Vijapurkar, U., Desai, M. and Davies, M. J. (2017) Effects of canagliflozin on cardiovascular biomarkers in older adults with type 2 diabetes. Journal of the American College of Cardiology, 70(6), pp. 704-712. (doi: 10.1016/j.jacc.2017.06.016) (PMID:28619659)

143184.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.



Background: Sodium glucose co-transporter 2 (SGLT2) inhibitors may reduce cardiovascular and heart failure risk in patients with type 2 diabetes mellitus (T2DM). Objectives: To examine the effects of canagliflozin on cardiovascular biomarkers in older patients with T2DM. Methods: In 666 T2DM patients randomized to receive canagliflozin 100 or 300 mg or placebo, we assessed median percent change in serum N-terminal pro-B type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hsTnI) , soluble (s)ST2, and galectin-3 from baseline to 26, 52, and 104 weeks. Results: Both serum NT-proBNP and serum hsTnI levels increased in placebo recipients but remained largely unchanged in those randomized to canagliflozin. Hodges-Lehmann estimates of the difference in median percent change between pooled canagliflozin and placebo were –15.0%, –16.1%, and –26.8% for NT-proBNP, and –8.3%, –11.9%, and –10.0% for hsTnI at weeks 26, 52, and 104, respectively (all P <0.05). Serum sST2 was unchanged with canagliflozin and placebo over 104 weeks. Serum galectin-3 modestly increased from baseline with canagliflozin versus placebo, with significant differences observed at 26 and 52 weeks but not at 104 weeks. These results remained unchanged when only patients with complete samples were assessed. Conclusions: Compared to placebo, treatment with canagliflozin delayed rise in serum NT-proBNP and hsTnI over 2 years in older T2DM patients. These cardiac biomarker data provide support for beneficial cardiovascular effect of SGLT2 inhibitors in T2DM.

Item Type:Articles
Additional Information:This study was sponsored by Janssen Scientific Affairs, LLC (Titusville, New Jersey). Medical writing support was provided by Alaina Mitsch, PhD, of MedErgy (Yardley, Pennsylvania), and was funded by Janssen Global Services, LLC (Raritan, New Jersey).
Keywords:N-terminal pro-B type natriuretic peptide, cardiovascular stress, galectin-3, high-sensitivity troponin, sodium glucose co-transporter 2 inhibitor, soluble ST2.
Glasgow Author(s) Enlighten ID:Sattar, Professor Naveed
Authors: Januzzi, J. L., Butler, J., Jarolim, P., Sattar, N., Vijapurkar, U., Desai, M., and Davies, M. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Journal of the American College of Cardiology
ISSN (Online):1558-3597
Published Online:12 June 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Journal of the American College of Cardiology 70(6):704-712
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record