Heart medication could help stop harmful blood clots

Researchers have identified a possible explanation for why sotagliflozin, a drug prescribed for some people with heart failure or diabetes-related risk factors, may offer heart protection. Laboratory work indicates it can make platelets less prone to forming dangerous clots.

Platelets are small blood cells that help close wounds. But when they become too active inside an artery, they can help create a blockage that cuts off blood flow to the heart or brain.

A University of Michigan study, using human blood samples and mouse models, was published in the Journal of Clinical Investigation. It helps explain earlier clinical observations, but it does not prove that this drug prevents more heart attacks than similar medicines.

Sotagliflozin is part of a class of drugs that influence how the body processes sugar. It blocks two related transport proteins, SGLT1 and SGLT2, while another commonly used medicine, empagliflozin, mainly acts on SGLT2.

The researchers set out to determine whether that distinction could matter for more than blood sugar control. They measured platelet activity in blood from healthy donors and people with type 2 diabetes, then examined clot formation after blood-vessel injury in mice.

In those tests, sotagliflozin reduced platelet activation and made platelets less likely to cluster together. Empagliflozin had little or no effect, suggesting the two drugs do not behave the same way in this aspect of clotting.

In the mouse experiments, clot formation dropped by about 60% with sotagliflozin. The reduction seen with empagliflozin was much smaller, around 5% to 10%, according to the university's summary of the work.

The team also removed SGLT1 specifically from mouse platelets. That change reduced clot formation by about 40%, offering another clue that this protein helps regulate how strongly platelets react to injury.

The results did not explain every part of the mechanism. A different drug that blocks only SGLT1 did not reproduce the full effect, indicating that more than one process may be involved.

In the experimental models, the researchers did not observe a disruption in normal bleeding control. That is encouraging, although it does not establish the long-term bleeding safety of using the drug specifically to prevent clots in people.

Sotagliflozin is already approved in the United States to reduce cardiovascular death and heart-failure-related hospital visits in certain patients with heart failure or diabetes, kidney disease and additional cardiovascular risks. This laboratory study does not broaden those approved uses.

The finding gives scientists a clearer direction for future work: heart protection may involve platelets as well as glucose handling. Clinical studies will be needed to determine how much this mechanism affects patient outcomes and whether it changes comparisons among treatments.

If you are interested in this topic, please read articles about Plant-based diets show promise in managing type 2 diabetes and heart disease, and Mediterranean diet could protect artery health, reduce heart disease risk.

For more information, please see articles about Common artificial sweeteners linked to higher risk of heart disease, and Omega-3 fatty acids and heart health: What you need to know.

Source: University of Michigan.