الفهرس 
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Abstract
Type 2 Diabetes continues to increase in prevalence throughout the world, and cardiovascular diseases remain the most common cause of morbidity and mortality among patients.
Vildagliptin is an oral agent of the DPP4 inhibitors which lower blood glucose in type 2 diabetes by blocking the dipeptidyl peptidase 4 enzyme which works to rapidly break down the hormone Glucagon Like Peptide 1 (GLP-1) which is released by cells in the small intestine after the ingestion of food.
The aim of this study was to evaluate the effect of Vildagliptin, adipeptidyl peptidase-4 (DPP-4) inhibitor, on cardiovascular outcome in comparison with Gliclazide, a sulfonylurea (SU), oral anti diabetic in patients with Type 2 Diabetes Mellitus and Acute coronary syndrome.
This study was conducted on 60 diabetic patients with recent acute coronary syndrome. The patients were randomized into two groups.Group(1) comprised 30 patients; 17 cases (56.7% ) were males and 13(43.3% ) were females, received gliclazide ( sulfonylurea group) taken orally twice daily for one year while Group(2) comprised of 30 patients;14 cases (46.7%) were males, and 16(53.3%) were females, received combination of gliclazide (sulfonylurea group) and vildagliptin (adipeptidyl peptidase-4 (DPP-4) inhibitor) taken orally once daily for one year. The two groups of treatment their ages ranged from 45 to 65 years old and their weight ranged from 75 to 90 kg.
A comparative study was carried out using these parameters: HBA1c, FBS, Lipid profile ( LDL, HDL, Triglyceride), EF% and Weight. Also Hypoglycemia and Rehospitalization of patients for any cardiovascular risk.
The results showed that there were a highly significant decrease in HbA1c and FBS level with p-value <0.05 in group (2) patients who were administering combination of Gliclazide and Vildagliptin after 3, 6 and 12 month follow up , which indicated proper improvement of blood glucose level after treatment among this group. A statistically significant decrease in LDL and triglyceride level plus statistically highly significance increase in HDL level in group (2) post 3and 6 months treatment indicated a proper improvement of lipid profile level (LDL, HDL, and triglyceride). In addition a statistically significant increase in echo finding (EF %) (p-value <0.05) post treatment with combination of Gliclazide and Vildagliptin for 3, 6 and 12 month in group2, indicated proper improvement in EF%. Finally, there were no statistically significance difference with p-value >0.05 regard weight, rehospitalization and hypoglycemia follow up between two groups, but there were risk of a cardiovascular event which was numerically, but not statistically, lower in those patients receiving the combination in group2.