The DPP-4 inhibitor sitagliptin and endothelial function in patients with acute coronary syndromes and newly detected glucose perturbations: A report from the BEGAMI study

OBJECTIVE: Compromised endothelial function contributes to poor prognosis in patients with coronary artery disease and type 2 diabetes. Incretin-based therapy may exert beneficial cardiovascular effects beyond glucose lowering. We tested whether sitagliptin improves endothelial function. RESEARCH DESIGN AND METHODS: In the double-blind BEta-cell function in patients with Glucose Abnormalities and Acute Myocardial Infarction (BEGAMI) trial, acute coronary syndrome (ACS)-patients with newly detected impaired glucose tolerance (IGT) or type 2 diabetes mellitus (T2DM) were randomised to sitagliptin 100 mg (n = 31) or placebo (n = 33) during 12 weeks. Endothelial function was studied as reactive hyperaemia index (RHI). RESULTS: At baseline, the RHI was slightly compromised in both groups (sitagliptin 1.67; Q1;Q3: 1.46;2.17 vs placebo 1.61; 1.44;1.96; ns). The RHI did not change during the study period and was 1.57 (1.40;2.36) in the sitagliptin and 1.60 (1.46;1.81; ns) in the placebo group after treatment. CONCLUSION: Sitagliptin did not improve endothelial function in patients with ACS and newly detected glucose perturbations.