Effects of linagliptin on endothelial function and postprandial lipids in coronary artery disease patients with early diabetes: a randomized, placebo‑controlled, double‑blind trial

Cardiovasc Diabetol, 2018 · DOI: https://doi.org/10.1186/s12933-018-0716-x · Published: May 10, 2018

Simple Explanation

This study investigated if linagliptin, a diabetes drug, could improve blood vessel function and post-meal fat levels in people with heart disease and early diabetes. Researchers measured blood vessel function using a test called flow-mediated dilation (FMD) and checked levels of fats and other substances in the blood after a meal. The study found that linagliptin did not significantly improve blood vessel function or fat levels compared to a placebo.

Study Duration

12 weeks

Participants

43 patients (21% female) with early diabetes and established CAD

Evidence Level

Level 1: Randomized, placebo-controlled, double-blind trial

Key Findings

1
Linagliptin treatment did not significantly improve flow mediated dilation (FMD) in patients with CAD and early T2DM compared to placebo.
2
There were no significant improvements in arginine bioavailability ratios (GABR and AOR) with linagliptin treatment.
3
HbA1c was significantly reduced with linagliptin treatment compared to placebo, but the extent was limited.

Research Summary

This study investigated the effect of linagliptin on endothelial function and postprandial lipid levels in subjects with coronary artery disease (CAD) and early type 2 diabetes mellitus (T2DM). The results showed that linagliptin did not improve flow mediated dilation (FMD) or other biochemical markers of endothelial function, nor did it significantly affect postprandial lipid levels. The study concludes that in subjects with early diabetes and established coronary artery disease, linagliptin has a neutral effect on various measurements of endothelial function.

Practical Implications

Limited Benefit in Established CAD

Linagliptin may not provide additional cardiovascular benefits in patients with established coronary artery disease and early diabetes.

Early Intervention Considerations

The timing of intervention with DPP-4 inhibitors may be critical, as the study suggests a neutral effect in individuals with early, well-controlled diabetes.

Further Research Needed

Additional studies are warranted to explore the effects of linagliptin in newly diagnosed diabetes patients without established cardiovascular disease.

Study Limitations

1
The study compared linagliptin against placebo and not an active control drug.
2
The trial duration of 3 months may be too short to demonstrate long-term benefits on endothelial function.
3
The overall number of subjects included, being 43, could be considered small.

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