Effects of alogliptin on fractional flow reserve evaluated by coronary computed tomography angiography in patients with type 2 diabetes: Rationale and design of the TRACT study

• Published in: Journal of cardiology 2017-03, Vol.69 (3), p.518-522
• Main Authors: Nozue, Tsuyoshi, MD, Fukui, Kazuki, MD, Takamura, Takeshi, MD, Sozu, Takashi, PhD, Hibi, Kiyoshi, MD, FJCC, Kishi, Satoru, MD, Michishita, Ichiro, MD, FJCC
• Format: Article
• Language: English
• Subjects: Aged; Alogliptin; Cardiovascular; Carotid Intima-Media Thickness; Computed Tomography Angiography; Coronary Angiography - methods; Coronary atherosclerosis; Coronary computed tomography angiography; Coronary Stenosis - drug therapy; Coronary Stenosis - physiopathology; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnostic imaging; Dipeptidyl peptidase-4 inhibitor; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; Female; Fractional flow reserve; Fractional Flow Reserve, Myocardial - drug effects; Humans; Hypoglycemic Agents - therapeutic use; Japan; Male; Middle Aged; Piperidines - therapeutic use; Plaque, Atherosclerotic - drug therapy; Prospective Studies; Uracil - analogs & derivatives; Uracil - therapeutic use
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2016.04.014

Abstract Background Patients with type 2 diabetes are at high risk for developing coronary artery disease (CAD). Noninvasive anatomic assessment by coronary computed tomography angiography (CCTA) is being increasingly used for detecting or excluding CAD. Recently, fractional flow reserve (FFR) using routinely acquired CCTA datasets (FFRCT ) has been developed. Although intensive glycemic control can reduce the risk of microvascular complications, intensive glucose control does not seem to be beneficial in preventing major cardiovascular events when compared with standard therapy. However, it has been reported that dipeptidyl peptidase-4 (DPP-4) inhibitors have anti-atherogenic effects in an animal model. In addition, DPP-4 inhibitors attenuate the progression of carotid intima-media thickness in patients with type 2 diabetes. Therefore, this study will be performed to evaluate the effects of alogliptin, a DPP-4 inhibitor, on coronary atherosclerosis using FFRCT in patients with type 2 diabetes. Methods and design This study will be a prospective, non-randomized, multicenter trial performed in Japan. Patients with type 2 diabetes who have intermediate coronary artery stenosis (diameter stenosis