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Cardiovascular Outcomes of Sitagliptin in Type 2 Diabetic Patients with Acute Myocardial Infarction, a Population-Based Cohort Study in Taiwan.

Wang SH, Chen DY, Lin YS, Mao CT, Tsai ML, Hsieh MJ, Chou CC, Wen MS, Wang CC, Hsieh IC, Hung KC, Chen TH - PLoS ONE (2015)

Bottom Line: We compared subjects using sitagliptin with comparison group to evaluate its cardiovascular safety and efficacy.Of these patients, 547 (16.7%) who were exposed to sitagliptin were defined as the sitagliptin group and 2,735 (83.3 %) who did not use sitagliptin were the comparison group.The use of sitagliptin in type 2 diabetic patients with recent AMI was not associated with increased risk of adverse cardiovascular events.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical education, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

ABSTRACT

Background: The cardiovascular safety and efficacy of sitagliptin, a dipeptidyl peptidase 4 (DPP-4) inhibitor, in type 2 diabetic patients after acute myocardial infarction (AMI) has so far remained uncertain.

Methods: We analyzed data from the National Health Insurance Research Database (NHIRD), a government-operated, population-based database, from March 1st, 2009 to December 31st, 2011. Type 2 diabetic patients hospitalized for AMI were included in our study. We compared subjects using sitagliptin with comparison group to evaluate its cardiovascular safety and efficacy. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and ischemic stroke.

Results: We identified a total of 3,282 type 2 diabetic patients hospitalized for AMI (mean follow-up 1.15 years). Of these patients, 547 (16.7%) who were exposed to sitagliptin were defined as the sitagliptin group and 2,735 (83.3 %) who did not use sitagliptin were the comparison group. The incidence of primary composite cardiovascular outcomes was 9.50 per 100 person-years in the sitagliptin group and was 9.70 per 100 person-years in the comparison group (hazard ratio (HR), 0.97; 95% CI, 0.73-1.29, P=0.849). Compared to the non-sitagliptin group, the sitagliptin group had similar risks of all-cause mortality, hospitalization for heart failure (HF) or percutaneous coronary intervention (PCI) with a HR of 0.82 (95% CI, 0.61-1.11, P=0.195), 0.93 (95% CI, 0.67-1.29, P=0.660), and 0.93 (95% CI, 0.75-1.14, P=0.473), respectively.

Conclusion: The use of sitagliptin in type 2 diabetic patients with recent AMI was not associated with increased risk of adverse cardiovascular events.

No MeSH data available.


Related in: MedlinePlus

Cumulative Kaplan-Meier survival estimates of the time to individual components of the primary composite endpoint and heart failure hospitalization.The sitagliptin and comparison groups had similar incidence of individual components of the primary composite endpoint, such as AMI (Panel A), ischemic stroke (Panel B), cardiovascular death (Panel C), and hospitalization for heart failure (Panel D).
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pone.0131122.g003: Cumulative Kaplan-Meier survival estimates of the time to individual components of the primary composite endpoint and heart failure hospitalization.The sitagliptin and comparison groups had similar incidence of individual components of the primary composite endpoint, such as AMI (Panel A), ischemic stroke (Panel B), cardiovascular death (Panel C), and hospitalization for heart failure (Panel D).

Mentions: As for secondary outcomes, the sitagliptin group had similar risks of all-cause mortality, hospitalization for heart failure (HF), or percutaneous coronary revascularization with an HR of 0.82 (95% CI, 0.61–1.11, P = 0.195), 0.93 (95% CI, 0.67–1.29, P = 0.660), and 0.93 (95% CI, 0.75–1.14, P = 0.473) respectively, compared to the non-sitagliptin group (Fig 3). Subgroup analysis revealed that sitagliptin use was not associated with increased risk of heart failure hospitalization in patients with previous history of heart failure (HR = 1.05; 95% CI, 0.71–1.56, P = 0.809) or without it (HR = 0.73; 95% CI, 0.40–1.33, P = 0.304).


Cardiovascular Outcomes of Sitagliptin in Type 2 Diabetic Patients with Acute Myocardial Infarction, a Population-Based Cohort Study in Taiwan.

Wang SH, Chen DY, Lin YS, Mao CT, Tsai ML, Hsieh MJ, Chou CC, Wen MS, Wang CC, Hsieh IC, Hung KC, Chen TH - PLoS ONE (2015)

Cumulative Kaplan-Meier survival estimates of the time to individual components of the primary composite endpoint and heart failure hospitalization.The sitagliptin and comparison groups had similar incidence of individual components of the primary composite endpoint, such as AMI (Panel A), ischemic stroke (Panel B), cardiovascular death (Panel C), and hospitalization for heart failure (Panel D).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4482692&req=5

pone.0131122.g003: Cumulative Kaplan-Meier survival estimates of the time to individual components of the primary composite endpoint and heart failure hospitalization.The sitagliptin and comparison groups had similar incidence of individual components of the primary composite endpoint, such as AMI (Panel A), ischemic stroke (Panel B), cardiovascular death (Panel C), and hospitalization for heart failure (Panel D).
Mentions: As for secondary outcomes, the sitagliptin group had similar risks of all-cause mortality, hospitalization for heart failure (HF), or percutaneous coronary revascularization with an HR of 0.82 (95% CI, 0.61–1.11, P = 0.195), 0.93 (95% CI, 0.67–1.29, P = 0.660), and 0.93 (95% CI, 0.75–1.14, P = 0.473) respectively, compared to the non-sitagliptin group (Fig 3). Subgroup analysis revealed that sitagliptin use was not associated with increased risk of heart failure hospitalization in patients with previous history of heart failure (HR = 1.05; 95% CI, 0.71–1.56, P = 0.809) or without it (HR = 0.73; 95% CI, 0.40–1.33, P = 0.304).

Bottom Line: We compared subjects using sitagliptin with comparison group to evaluate its cardiovascular safety and efficacy.Of these patients, 547 (16.7%) who were exposed to sitagliptin were defined as the sitagliptin group and 2,735 (83.3 %) who did not use sitagliptin were the comparison group.The use of sitagliptin in type 2 diabetic patients with recent AMI was not associated with increased risk of adverse cardiovascular events.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical education, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

ABSTRACT

Background: The cardiovascular safety and efficacy of sitagliptin, a dipeptidyl peptidase 4 (DPP-4) inhibitor, in type 2 diabetic patients after acute myocardial infarction (AMI) has so far remained uncertain.

Methods: We analyzed data from the National Health Insurance Research Database (NHIRD), a government-operated, population-based database, from March 1st, 2009 to December 31st, 2011. Type 2 diabetic patients hospitalized for AMI were included in our study. We compared subjects using sitagliptin with comparison group to evaluate its cardiovascular safety and efficacy. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and ischemic stroke.

Results: We identified a total of 3,282 type 2 diabetic patients hospitalized for AMI (mean follow-up 1.15 years). Of these patients, 547 (16.7%) who were exposed to sitagliptin were defined as the sitagliptin group and 2,735 (83.3 %) who did not use sitagliptin were the comparison group. The incidence of primary composite cardiovascular outcomes was 9.50 per 100 person-years in the sitagliptin group and was 9.70 per 100 person-years in the comparison group (hazard ratio (HR), 0.97; 95% CI, 0.73-1.29, P=0.849). Compared to the non-sitagliptin group, the sitagliptin group had similar risks of all-cause mortality, hospitalization for heart failure (HF) or percutaneous coronary intervention (PCI) with a HR of 0.82 (95% CI, 0.61-1.11, P=0.195), 0.93 (95% CI, 0.67-1.29, P=0.660), and 0.93 (95% CI, 0.75-1.14, P=0.473), respectively.

Conclusion: The use of sitagliptin in type 2 diabetic patients with recent AMI was not associated with increased risk of adverse cardiovascular events.

No MeSH data available.


Related in: MedlinePlus