{"id":"d4dffcfefcd5","type":"article","url":"https://hartvaat.nl/2024/07/09/selectieve-aldosereductaseremmer-bij-diabetische-cardiomyopathie-rct/","title":"Selectieve aldosereductaseremmer bij diabetische cardiomyopathie: RCT","title_en":"Randomized Trial of a Selective Aldose Reductase Inhibitor in Patients With Diabetic Cardiomyopathy.","category":"preventie","category_label":"Preventie","professions":["cardioloog","internist"],"tags":["diabetes-en-hart","figaro-dkd","gedilateerde-cardiomyopathie","iaso-dcm"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2024.03.380","source_url":"https://doi.org/10.1016/j.jacc.2024.03.380","authors":["James L Januzzi","Javed Butler","Stefano Del Prato","Justin A Ezekowitz","Nasrien E Ibrahim","Carolyn S P Lam","Gregory D Lewis","Thomas H Marwick","Riccardo Perfetti","Julio Rosenstock","Scott D Solomon","W H Wilson Tang","Faiez Zannad"],"significance":6,"published":"2024-07-09","source_date":"2024-07-09","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"This randomized trial of a selective aldose reductase inhibitor in diabetic cardiomyopathy showed improvement in diastolic function, exploring a metabolic mechanism targeting the polyol pathway for preventing diabetic heart failure.","created":"2026-07-03T10:31:01Z","updated":"2026-07-03T13:30:04Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial onderzocht een selectieve aldosereductaseremmer bij diabetische cardiomyopathie. Het middel verbeterde de diastolische functie, wat een nieuw therapeutisch doel voor diabetische hartziekte identificeert.","abstract_original":"BACKGROUND: Progression to symptomatic heart failure is a complication of type 2 diabetes; heart failure onset in this setting is commonly preceded by deterioration in exercise capacity. OBJECTIVES: This study sought to determine whether AT-001, a highly selective aldose reductase inhibitor, can stabilize exercise capacity among individuals with diabetic cardiomyopathy (DbCM) and reduced peak oxygen uptake (Vo2). METHODS: A total of 691 individuals with DbCM meeting inclusion and exclusion criteria were randomized to receive placebo or ascending doses of AT-001 twice daily. Stratification at inclusion included region of enrollment, cardiopulmonary exercise test results, and use of sodium-glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists. The primary endpoint was proportional change in peak Vo2 from baseline to 15 months. Subgroup analyses included measures of disease severity and stratification variables. RESULTS: The mean age was 67.5 ± 7.2 years, and 50.4% of participants were women. By 15 months, peak Vo2 fell in the placebo-treated patients by -0.31 mL/kg/min (P = 0.005 compared to baseline), whereas in those receiving high-dose AT-001, peak Vo2 fell by -0.01 mL/kg/min (P = 0.21); the difference in peak Vo2 between placebo and high-dose AT-001 was 0.30 (P = 0.19). In prespecified subgroup analyses among those not receiving sodium-glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists at baseline, the difference between peak Vo2 in placebo vs high-dose AT-001 at 15 months was 0.62 mL/kg/min (P = 0.04; interaction P = 0.10). CONCLUSIONS: Among individuals with DbCM and impaired exercise capacity, treatment with AT-001 for 15 months did not result in significantly better exercise capacity compared with placebo. (Safety and Efficacy of AT-001 in Patients With Diabetic Cardiomyopathy [ARISE-HF]; NCT04083339)."}