The effect of sitagliptin on myocardial performance in patients with type 2 diabetes and coronary artery disease

Research summary

An inadequate supply of oxygen to the heart, due to narrowed coronary arteries, may result in impaired contractile performance during exercise. The use of glucose rather than fat as the major energy source may enable the heart to continue pumping normally despite the constrained delivery of oxygen. Glucagon-like peptide-1 (GLP-1) has been shown to promote myocardial glucose use. The breakdown of GLP-1 can be inhibited by sitagliptin (Januvia, MSD) which is licensed for the treatment of type 2 diabetes. We have shown that a single dose of sitagliptin produces an acute improvement in cardiac performance on exercise in patients with coronary disease. This study will assess whether a longer period of treatment with sitagliptin for 4 weeks will produce a chronic improvement in myocardial performance in patients with type 2 diabetes.


Main inclusion criteria

  1. Type 2 diabetes on treatment with metformin, a sulphonylurea or a thiazolidinedione

  2. Known coronary artery disease

  3. Good left ventricular function

  4. Sinus rhythm

Main exclusion criteria

  1. Type 1 diabetes

  2. Treatment with insulin, exenatide, sitagliptin or vildagliptin

  3. Renal impairment (creat > 175 micromol/l)

  4. Hepatic impairment

  5. Poor left ventricular function

  6. Atrial fibrillation

  7. Permanent pacemaker

  8. Significant valvular heart disease or other structural heart disease

Chief investigator

Dr David Dutka

Contact details

Senior Clinical Trials Coordinator: Heike Templin

Telephone: 01223 250874 | Email: [email protected]