Evaluation of the effects of dapagliflozin on subclinical atherosclerosis with two non-invasive methods: pulse wave velocity and carotid intima-media thickness.

OBJECTIVE: Recent cardiovascular outcome trials have shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors reduce cardiovascular events, but results regarding their effects on subclinical atherosclerosis are conflicting. In this study, we aimed to investigate the effect of dapagliflozin, a selective SGLT2 inhibitor, on subclinical atherosclerosis by monitoring pulse wave velocity (PWV) and carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS: Forty-eight patients with T2DM and on dapagliflozin treatment were included in the study. Demographic variables, anthropometric indices and laboratory parameters were obtained from the patient files. Baseline and 6th-month PWV and cIMT values were obtained. The percentage changes from baseline in all continuous variables with six months of dapagliflozin were calculated.

RESULTS: Compared to baseline values, we found that cIMT decreased from 0.70 (0.50-1.10) mm to 0.60 (0.40-1.00) mm and PWV decreased from 9.52 ± 1.59 m/s to 9.16 ± 1.55 m/s in the 6th month of treatment (p < 0.001 and p < 0.001, respectively). The percentage decrease in cIMT (ΔcIMT) was 14.65 ± 11.88% and in PWV (ΔPWV) was 3.76 ± 4.08%. ΔcIMT was positively correlated with baseline cIMT, BMI and fat mass values (p = 0.019, p = 0.023 and p = 0.030, respectively). 1PWV was positively correlated with baseline systolic blood pressure (p = 0.020).

CONCLUSIONS: According to the results of our study, dapagliflozin treatment reduces PWV and cIMT, and the decrease in these markers was greater among patients with higher baseline SBP, cIMT, BMI and fat mass. These results suggest that, if supported by more comprehensive studies, the cardiovascular benefits of dapagliflozin may be greater in patients with higher baseline cardiovascular risk.