Comparing the Effects of Oral Antidiabetic Drugs Semaglutide and Dapagliflozin Versus Metformin on Coronary Artery Disease in Adults With Pre-diabetes

What this Trial Is About

Researchers are investigating the effects of three different antidiabetic drugssemaglutide, dapagliflozin, and metforminon patients with pre-diabetes and coronary artery disease. The study aims to compare how these treatments influence the progression or regression of coronary atherosclerosis, changes in plaque characteristics, and control of cardiovascular risk factors over 24 months. Coronary artery disease diagnosis is confirmed by coronary CT scans showing atherosclerosis. Participants will be randomly assigned to receive either semaglutide started at 3 mg daily and increased to 14 mg daily if tolerated, dapagliflozin 10 mg daily, or metformin 500 mg daily, up to 1000 mg if needed. All groups will also receive optimal medical therapy and lifestyle interventions including cardiological counseling, dietary advice, physical activity guidance, smoking cessation support if applicable, and psychological counseling. During the study, participants will undergo evaluations to assess coronary artery disease progression using coronary CT scans and monitor changes in cardiovascular risk factors and body measurements. Researchers will track compliance with physical activity and diet, inflammatory and lipid markers, blood sugar control, and major cardiovascular events over the 24-month period. Safety and treatment effects will be carefully monitored throughout the trial period.

Anti-atherosclerotic Efficacy of Selected Antidiabetic Drugs in Patients With Coronary Artery Disease and Pre-diabetes