國家衛生研究院 NHRI:Item 3990099045/11341
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    题名: Cardiovascular benefits of acarbose versus sulfonylureas in type 2 diabetic patients treated with metformin
    作者: Hsu, PF;Sung, SH;Cheng, HM;Shin, SJ;Lin, KD;Chong, K;Yen, FS;Yu, BH;Huang, CT;Hsu, CC
    贡献者: Institute of Population Health Sciences
    摘要: Context: Althoughalpha-glucosidase inhibitor (AGI) has been shown to reduce the risk of myocardial infarction in patients with impaired glucose tolerance (IGT), the cardiovascular benefits of AGI in type 2 diabetes (T2D) remains unclear. Objective: We aimed to compare clinical outcomes of adding acarbose versus sulfonylureas to metformin therapy in T2D patients. Design, Setting, and Participants: The study population was drawn from the database of the Diabetes Pay-for-Performance (P4P) Program in Taiwan. Sulfonylureas and acarbose were respectively prescribed to 196,143 and 14,306 T2D patients during 2004-2015, who had been treated with metformin. A propensity score-matched cohort study was conducted. Patients were followed for clinical adverse events of all-cause mortality and hospitalizations of major atherosclerotic events (myocardial infarction and ischemic stroke), heart failure or hypoglycemia. Results: A total of 14,306 propensity score-matched pairs (55.8+/-13.1 years, 47.8% men) were enrolled in this analysis. Compared with sulfonylureas as the add-on therapy to metformin, the use of acarbose was associated with significantly lower risks of hospitalizations for major atherosclerotic events (hazard ratio and 95% confidence intervals: 0.69, 0.52-0.91), ischemic stroke (0.68, 0.49-0.94), and hypoglycemia (0.23, 0.08-0.71), after accounting for major confounding factors. Conclusions: In T2D treatment, use of acarbose as the add-on remedy to metformin was associated with lower risks of major atherosclerotic events, ischemic stroke, and hypoglycemia, compared with sulfonylurea.
    日期: 2018-10
    關聯: Journal of Clinical Endocrinology and Metabolism. 2018 Oct;103(10):3611-3619.
    Link to: http://dx.doi.org/10.1210/jc.2018-00040
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0021-972X&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000448258100005
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85054459941
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