Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Cardiovasc Diabetol. 2021 Feb 11;20(1):41. doi: 10.1186/s12933-021-01234-5.
Clinical trials are often performed to investigate the effects of various types of cardiometabolic therapies on cardiovascular surrogate markers, including vascular function and biomarkers. This study platform has the potential to provide information on the suspected actions of drugs and mechanistic insights into their prognostic impact. However, despite using the same class of drugs and similar study designs we are often faced with inconsistent and even conflicting results, possibly leading to some confusion in the clinical setting. When interpreting these results, it is important to investigate what caused the differences and carefully assess the information, taking into account the research situation and the patient population investigated. Using this approach, assessment of the impact on cardiovascular surrogate markers observed in clinical studies from multiple perspectives should help to better understand the potential cardiovascular effects. In this commentary we discuss how we should interpret the effects of cardiometabolic therapeutics on vascular surrogate markers, based on viewpoints learned from the results of clinical trials on dipeptidyl peptidase-4 inhibitors. This learning strategy could also be helpful for appropriate selection of drugs for evidence-based, patient-centric, tailored medication.
临床试验通常用于研究各种心血管代谢疗法对血管功能和生物标志物等心血管替代标志物的影响。该研究平台有可能提供有关药物可疑作用的信息，并深入了解其预后影响的机制。然而，尽管使用了相同类别的药物和类似的研究设计，我们经常面临不一致甚至相互矛盾的结果，这可能导致临床实践中的一些困惑。在解释这些结果时，重要的是要调查导致差异的原因，并仔细评估信息，同时考虑研究情况和研究的患者人群。通过这种方法，从多个角度评估临床研究中观察到的对心血管替代标志物的影响，有助于更好地理解潜在的心血管作用。在本评论中，我们将根据二肽基肽酶-4 抑制剂临床试验结果得出的观点，讨论如何解释心血管代谢治疗对血管替代标志物的影响。这种学习策略对于基于证据、以患者为中心、量身定制的药物选择也可能有帮助。
