Effect of sarpogrelate, a selective 5-HT 2A receptor antagonist, on characteristics of coronary artery disease in patients with type 2 diabetes

• Published in: Atherosclerosis 2017-02, Vol.257, p.47-54
• Main Authors: Lee, Dong-Hwa, Chun, Eun Ju, Hur, Jee Hye, Min, Se Hee, Lee, Jie-Eun, Oh, Tae Jung, Kim, Kyoung Min, Jang, Hak Chul, Han, Seung Jin, Kang, Doo Kyoung, Kim, Hae Jin, Lim, Soo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ankle Brachial Index; Anti-Inflammatory Agents - therapeutic use; Aspirin - therapeutic use; Biomarkers - blood; Computed Tomography Angiography; Coronary Angiography - methods; Coronary Artery Disease - blood; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - drug therapy; Coronary Stenosis - complications; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - drug therapy; Coronary Vessels - diagnostic imaging; Coronary Vessels - drug effects; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Drug Therapy, Combination; Female; Humans; Insulin Resistance; Male; Middle Aged; Multidetector Computed Tomography; Plaque, Atherosclerotic; Platelet Aggregation Inhibitors - adverse effects; Platelet Aggregation Inhibitors - therapeutic use; Pulse Wave Analysis; Republic of Korea; Serotonin 5-HT2 Receptor Antagonists - adverse effects; Serotonin 5-HT2 Receptor Antagonists - therapeutic use; Severity of Illness Index; Succinates - adverse effects; Succinates - therapeutic use; Time Factors; Treatment Outcome; Vascular Calcification - diagnostic imaging; Vascular Calcification - drug therapy
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2016.12.011

Sarpogrelate, a 5-hydroxytryptamine type 2A antagonist, is a potential antiplatelet agent. We performed a randomized study to evaluate the effect of sarpogrelate on vascular health in Korean patients with diabetes. Forty diabetic patients aged 58.6 ± 6.8 years with 10-75% coronary artery stenosis, as assessed by coronary computed tomography angiography, were randomly assigned to sarpogrelate 300 mg/day plus aspirin 100 mg/day (SPG + ASA group) or aspirin 100 mg/day alone (ASA group) for 6 months. The primary endpoint of this study was the change in coronary artery disease including the calcium score (CACS), maximal stenosis, and plaque volume (calcified vs. noncalcified). The secondary endpoints were changes in biochemical parameters related to glucose and lipid metabolism, and in subclinical atherosclerosis assessed by ankle-brachial index and pulse wave velocity. After 6-month treatment, there was no significant difference in the changes in CACS, coronary stenosis, ankle-brachial index, and pulse wave velocity, between groups. The total plaque volume decreased from 82.4 ± 14.5 mm to 74.6 ± 14.4 mm in the SPG + ASA group, but increased from 64.9 ± 16.0 mm to 68.6 ± 16.3 mm in the ASA group (p