Impact of baseline left ventricular ejection fraction and body mass index on the effect of 24-week Ipragliflozin treatment on left ventricular diastolic function in patients with type 2 diabetes and chronic kidney disease: insights from the PROCEED trial
Authors' conclusion
In subgroups with higher LVEF and BMI, ipragliflozin improved diastolic function more than standard treatment. These results may partly support the beneficial effect of SGLT2 inhibitors on LV diastolic performance.
Study context
- Population
- Patients with T2D and chronic kidney disease (CKD) in the PROCEED trial with echocardiography data at baseline and 24 weeks
- Participants
- 57 patients
- Comparison
- Ipragliflozin vs non-SGLT2 inhibitor standard therapy
- Ipragliflozinn = 28
- Controln = 29reference
- Primary endpoint
- Change in E/e' ratio (index of left ventricular (LV) diastolic function)
- Follow-up
- Baseline to 24 weeks
Methodological detailssubgroup analysis stratified by baseline LVEF, body mass index (BMI), N-terminal pro-brain natriuretic peptide (NT-proBNP), estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR)
- Subgroup analysis stratified by baseline LVEF, BMI, NT-proBNP, eGFR and UACR
Primary result
As reported in the abstract
24 weeks
- LVEF ≥ 60% (n = 21)
- group difference - 1.42 (CI - 2.76 to - 0.08); P = 0.038
- LVEF < 60% (n = 7)
- group difference 1.83 (CI - 4.48 to 8.14); P = 0.527
- BMI ≥ 25 kg/m² (n = 19)
- group difference - 1.95 (CI - 3.56 to - 0.34); P = 0.020
- BMI < 25 kg/m² (n = 9)
- group difference 1.34 (CI - 1.65 to 4.34); P = 0.363
- Interaction LVEF ≥ 60% vs < 60%
- P for interaction = 0.048
- Interaction BMI ≥ 25 vs < 25 kg/m²
- P for interaction = 0.016
Further findings
| Outcome | Group difference (95% CI) | P value |
|---|---|---|
| Change in E/e' ratio, overall · 24 weeksNo significant difference | - 0.82 (- 2.44 to 0.81) | P = 0.317 |
E/e' ratio by baseline NT-proBNP, eGFR and UACR
- E/e' ratio was unaffected by baseline NT-proBNP, eGFR and UACR levels
Original publication
Impact of baseline left ventricular ejection fraction and body mass index on the effect of 24-week Ipragliflozin treatment on left ventricular diastolic function in patients with type 2 diabetes and chronic kidney disease: insights from the PROCEED trial. Cardiovasc Diabetol. Published 2 May 2025. doi:10.
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