Effect of Canagliflozin on endothelial function in diabetic patients with suspected coronary artery disease: retrospective preliminary pilot study

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Background: Sodium-glucose transporter-2 inhibitor (SGLT2) is reported to have anti-atherosclerotic effects in experiment. However, the effect of SGLT2 on endothelial function (ECF) in humans is not fully investigated. Method and Results: We measured ECF in 11 diabetic patients with coronary artery disease (CAD) and poor control of diabetics (HbA1c>7%; 75±8 years old) by simultaneously measuring brachial artery flow-mediated dilation (FMD) and EndoPAT2000 (measuring RHI). FMD and RHI were measured before and after mean periods of 4-week treatment of Canagliflozin (100 mg per every other day). Canagliflozin improved HbA1c along with increasing FMD and RHI (HbA1c, 9.2±1.4 vs. 8.6±1.1%, P<0.01; FMD, 6.40±1.29 vs. 8.98±1.68%, P<0.01; RHI, 1.5±0.3 vs.1.8±0.3, P<0.05). In addition, the changes of HbA1c did not tend to correlate with either FMD or RHI. Conclusions: Since the improved FMD and RHI reflect salutary effect of Canagliflozin on ECF, these results might suggest that SGLT2 could have anti-arteriosclerotic effects in diabetics with CAD.