Anti-atherosclerotic Efficacy of Selected Antidiabetic Drugs in Patients With Coronary Artery Disease and Pre-diabetes

Korábbi kezelés

• Status after coronary artery bypass surgery
• Use of weight-loss drugs
• Other known contraindications to treatment with metformin, dapagliflozin or semaglutide

Más betegség

• Clinical condition requiring surgical treatment of coronary artery disease
• Other severe medical conditions requiring scheduled hospital treatment at the time of the study
• Severe musculoskeletal conditions requiring specific rehabilitation recommendations
• Diagnosed heart failure
• Presence of an artificial valve, cardiac pacing system or other implantable device (such as a cardioverter defibrillator)
• Severe arrhythmia/unexplained loss of consciousness
• Condition after bariatric surgery
• Pancreatic cancer
• Medullary thyroid cancer
• History of anaphylactic shock after iodine contrast administration
• History of pancreatitis or active pancreatitis

Laborértékek

• Diagnosed diabetes or Hba1c>=6.5% at screening/randomization appointment
• Use of glucose-lowering drugs other than metformin
• Diagnosed liver disease or ALT, AST above three times the upper limit of normal at screening appointment
• Chronic kidney disease (eGFR <45 ml/min/1.73 m2)

Egyéb

• Severe valvular defect
• Other contraindications to physical activity
• No consent to participate in the study
• Uncompensated hyperthyroidism
• Body mass index (BMI) >40 kg/m2
• Pregnancy/lactation
• Participation in another clinical trial

• Age 18 - 80
• Diagnosed coronary artery disease (coronary artery stenosis of at least 20% with a reference diameter of >2.5 mm or status after percutaneous coronary revascularization procedure found on coronary CT scan)
• Coronary CT scan performed <3 months after inclusion in the study, at least of good quality
• Pre-diabetic status defined as fasting blood glucose 100-125 mg% or Hba1c 5.70-6.49% (measurement documented at the screening/randomization appointment or within 30 days prior to the screening/randomization appointment) or documented, positive result of an oral glucose load test (fasting blood glucose 100-125 mg% and 140-199 mg% 2h after a 75 g oral glucose load) performed up to 30 days before the screening/randomization appointment
• Stable treatment and control of cardiovascular risk factors, including dietary and lifestyle management for at least 4 weeks
• Willing and able to give informed consent to participate in the study
• Willing and able, according to the researcher, to comply with all the requirements of the study