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Vol. 19, Art. 47 (pp. 636-662)    |    2018       

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Effect of the sodium-glucose cotransporter-2 inhibitor empagliflosin on certain clinical-laboratory parameters of the cardiovascular system in patients with type 2 diabetes mellitus and high cardiovascular risk

Kotova M.Е., Maxim О.V., Salukhov V.V., Dobrovolskaya L.M., Romashevsky B.V., Sardinov R.T., Kovalevskaya E.A., Kitsyshin V.P., Eliseeva T.V., Rud S.D., Samoilov A.O., Titov D.G.

S.M. Kirov Military Medical Academy, Saint Petersburg, Russia

Brief summary

patients with type 2 diabetes mellitus are at higher risk of cardiovascular complications. However, the hypoglycemic drugs used previously in clinical practice did not significantly reduce the cardiovascular risks. Empagliflozin is a relatively new drug, characterized not only by excellent hypoglycemic action, but also by cardioprotective properties. Objective: to study the effect on the cardiovascular system of empagliflozin in combination with traditional hypoglycemic agents compared with standard glucose-lowering therapy for treating patients with type 2 diabetes mellitus with high cardiovascular risk. Methods: the study screened 48 patients with t2dm and associated cardiovascular conditions, which were subsequently divided into 2 groups: those treated with empagliflozin (10 mg or 25 mg; n = 34) and the group of patients (n = 14) who received the usual sugar-lowering therapy . Additionally, a sub-research subgroup was distinguished (n = 10). The study had a parallel design, the duration of therapy was 52 weeks. The diagnostic complex included an assessment of physical data, a subjective assessment of the state of one's health by the patient, and laboratory and instrumental research methods. Results: the use of empagliflozin for the treatment of t2dm resulted in a decrease in the level of hba1c (7.432 ? 0.156 (p <0.05)), while the level of glycemia after reduction decreased at a stable level throughout the study. During treatment with empagliflozin, there was a decrease in body weight and its retention over the entire observation period, as well as a decrease in the level of uric acid. Receiving empagliflozin has a positive effect on the cardiovascular system in the form of a decrease in systolic and diastolic blood pressure (p <0.05), an increase in exercise tolerance, as well as a decrease in heart rate, a decrease in the number of episodes of supraventricular and ventricular tachycardias, as well as a decrease in the end diastolic ventricular volume (p <0.05). According to the questionnaires (eq-5d and kccq), taking empagliflozin resulted in a significant improvement in health status and quality of life (p <0.01). During the study, adverse events (aes) were observed, comparable in frequency in the experimental and control groups. Adverse reactions were represented by hypoglycemia and infections of the genitourinary system, while none of the adverse events required the abolition of empagliflozin. Conclusion: the use of empagliflozin helps to improve myocardial function by reducing preload, reducing afterload without increasing heart rate and with a positive effect on the structure of myocardial ectopic activity. Empagliflozin therapy leads to the improvement of certain metabolic parameters (body weight, glycemia, hba1c, uric acid), as well as to improved health and quality of life.affiliation


Key words

type 2 diabetes; empagliflozin; sodium type 2 glucose cotransporter inhibitors; cardiovascular safety; coronary heart disease.

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