Vildagliptin in Ventricular Dysfunction Diabetes


eMediNexus Editorial    18 December 2017

A new study published in the Journal of the American College of Cardiology demonstrated that vildagliptin is non-inferior for change in left ventricular ejection fraction (LVEF) among patients with type-2 diabetes mellitus (DM2) and prior heart failure (HF), with an increase in left ventricular (LV) systolic and diastolic volumes over 52 weeks of follow-up. The goal of the VIVIDD trial was to assess the safety of vildagliptin, a novel dipeptidyl peptidase-4 (DPP-4) inhibitor, among patients with DM2 and pre-existing HF.

In this randomized trial patients (with a mean age of 63 years; 23% females) were assigned to either vildagliptin 50 mg, twice daily (n = 128) or placebo (n = 126), and followed-up for 52 weeks.

The results revealed that for vildagliptin the adjusted mean change in LVEF was 4.95%, whereas for placebo the change was found to be 4.33%. In addition, when comparing vildagliptin to the placebo, the difference in adjusted mean change in LV end-diastolic volume was 17.06; difference in adjusted mean change in LV end-systolic volume was 9.44; the rate of major adverse cardiac events was 27.3% and 24.6%, respectively; the rate of cardiovascular death 5.5% and 3.2%, respectively; the rate of all-cause death was 8.6% and 3.2%, respectively; worsening heart failure was 18.0%and 17.5%, respectively; and the adjusted mean change from baseline in glycated hemoglobin (HbA1c) at 16 weeks was 0.45% and 0.17%, respectively.

From the findings of this study, it was stated that vildagliptin, a novel DPP-4 inhibitor, is non-inferior for change in LVEF among patients with DM2 and prior HF, with an increase in LV systolic and diastolic volumes over 52 weeks of follow-up. It was also noted that the incidence of worsening HF was similar, while all-cause mortality was numerically higher in the vildagliptin arm.

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