The effects of empagliflozin, a sodium-glucose co-transporter 2 inhibitor, on neointimal response after drug-eluting-stent (DES) implantation remains unknown. Insufficiently controlled diabetes patients with coronary artery disease planned for DES stenting were consecutively enrolled. The patients were assigned to receive empagliflozin in addition to standard therapy or intensive therapy using other glucose-lowering drugs (oGLD). The primary endpoint was thickness of neointimal hyperplasia (NIH) 12 months after stenting assessed by optical coherence tomography (OCT). A total of 28 patients were analyzed (n = 15 in the empagliflozin group, n = 13 in the oGLD group). The levels of glucose profile were not significantly different between both groups at follow-up [HbA1c; 7.2 ± 0.8 vs 7.3 ± 0.9%, p = 0.46]. In OCT analysis, neointima was significantly less in the empagliflozin group than the oGLD group [mean NIH thickness: 137 ± 32 vs 168 ± 39 μm, p = 0.02]. Changes of systolic and diastolic blood pressure (BP), changes of body mass index, and changes of hematocrit after additional treatment were significantly associated with NIH attenuation, whereas no correlation was observed in changes in blood glucose parameters. Multivariate logistic regression analysis revealed that changes in systolic BP was the strongest predictor for NIH attenuation, followed by changes in diastolic BP. In patients with type 2 diabetes, standard plus empagliflozin attenuated neointimal progression as compared with intensive standard therapy after DES implantation. Our data possibly support a beneficial effect of empagliflozin in type 2 diabetes required for coronary revascularization therapy.

中文翻译：

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Empagliflozin可减轻2型糖尿病患者药物洗脱支架植入后的内膜增生。

恩帕格列净（钠-葡萄糖共转运蛋白2抑制剂）对药物洗脱支架（DES）植入后新内膜反应的影响尚不清楚。计划纳入DES支架置入的控制不足的糖尿病冠心病患者。除了使用其他降糖药物（oGLD）的标准疗法或强化疗法外，患者还被分配接受依帕列净治疗。主要终点是通过光学相干断层扫描（OCT）评估支架置入后12个月的新生内膜增生（NIH）的厚度。共分析了28位患者（恩帕格列净组n = 15，oGLD组n = 13）。随访时两组之间的葡萄糖谱水平无显着差异[HbA1c; 7.2±0.8与7.3±0.9％，p = 0.46]。在OCT分析中，依帕列净组的新内膜明显少于oGLD组[平均NIH厚度：137±32 vs 168±39μm，p = 0.02]。额外治疗后收缩压和舒张压（BP）的变化，体重指数的变化以及血细胞比容的变化与NIH衰减显着相关，而血糖参数的变化则没有相关性。多元logistic回归分析显示，收缩压的变化是NIH衰减最强的预测指标，其次是舒张压的变化。在2型糖尿病患者中，与DES植入后的强化标准治疗相比，标准加依帕列净治疗可减轻新内膜的进展。