Timed bromocriptine-QR therapy reduces progression of cardiovascular disease and dysglycemia in subjects with well-controlled type 2 diabetes mellitus

Background: type 2 diabetes (t2dm) patients,including those in good glycemic control,have an increased risk of cardiovascular disease (cvd). maintaining good glycemic control may reduce long-term cvd risk. however,other risk factors such as elevated vascular sympathetic tone and/or endothelial dysfunction may be stronger potentiators of cvd. this study evaluated the impact of bromocriptine-qr,a sympatholytic dopamine d2 receptor agonist,on progression of metabolic disease and cvd in t2dm subjects in good glycemic control (hba1c ≤7.0%). methods: 1834 subjects (1219 bromocriptine-qr; 615 placebo) with baseline hba1c ≤70% derived from the cycloset safety trial (this trial is registered with clinicaltrials.gov identifer: nct00377676),a 12-month,randomized,multicenter,placebo-controlled,double-blind study in t2dm,were evaluated. treatment impact upon a prespecified composite cvd endpoint (first myocardial infarction,stroke,coronary revascularization,or hospitalization for angina/congestive heart failure) and the odds of losing glycemic control (hba1c >70% after 52 weeks of therapy) were determined. results: bromocriptine-qr reduced the cvd endpoint by 48% (intention-to-treat; hr: 0.52 [0.28-0.98]) and 52% (on-treatment analysis; hr: 0.48 [0.24-0.95]). bromocriptine-qr also reduced the odds of both losing glycemic control (or: 0.63 (0.47-0.85),p = 0.002) and requiring treatment intensification to maintain hba1c ≤70% (or: 0.46 (0.31-0.69),p = 0.0002). conclusions: bromocriptine-qr therapy slowed the progression of cvd and metabolic disease in t2dm subjects in good glycemic control. copyright © 2015 bindu chamarthi et al.