The Effects of Glucose Lowering Agents on the Secondary Prevention of Coronary Artery Disease in Patients with Type 2 Diabetes

Overview

Journal Endocrinol Metab (Seoul)

Specialty Endocrinology

Date 2021 Oct 14

PMID 34645126

Citations 2

Authors

Inha Jung

Hyemi Kwon

Se Eun Park

Kyung-Do Han

Yong-Gyu Park

Eun-Jung Rhee

Won-Young Lee

Affiliations

Soon will be listed here.

Abstract

Background: Patients with diabetes have a higher risk of requiring repeated percutaneous coronary intervention (PCI) than non-diabetic patients. We aimed to evaluate and compare the effects of anti-diabetic drugs on the secondary prevention of myocardial infarction among type 2 diabetes mellitus patients.

Methods: We analyzed the general health check-up dataset and claims data of the Korean National Health Insurance Service of 199,714 participants (age ≥30 years) who underwent PCIs between 2010 and 2013. Those who underwent additional PCI within 1 year of their first PCI (n=3,325) and those who died within 1 year (n=1,312) were excluded. Patients were classified according to their prescription records for glucose-lowering agents. The primary endpoint was the incidence rate of coronary revascularization.

Results: A total of 35,348 patients were included in the study. Metformin significantly decreased the risk of requiring repeat PCI in all patients (adjusted hazard ratio [aHR], 0.77). In obese patients with body mass index (BMI) ≥25 kg/m2, patients treated with thiazolidinedione (TZD) exhibited a decreased risk of requiring repeat revascularization than those who were not treated with TZD (aHR, 0.77; 95% confidence interval, 0.63 to 0.95). Patients treated with metformin showed a decreased risk of requiring revascularization regardless of their BMI. Insulin, meglitinide, and alpha-glucosidase inhibitor were associated with increased risk of repeated PCI.

Conclusion: The risk of requiring repeat revascularization was lower in diabetic patients treated with metformin and in obese patients treated with TZD. These results suggest that physicians should choose appropriate glucose-lowering agents for the secondary prevention of coronary artery disease.

Citing Articles

Establishment of a Predictive Model for Poor Prognosis of Incomplete Revascularization in Patients with Coronary Heart Disease and Multivessel Disease.

Lian H, Zhao Z, Ma K, Ding Z, Sun L, Zhang Y Clin Appl Thromb Hemost. 2022; 28:10760296221139258.

PMID: 36573034 PMC: 9806495. DOI: 10.1177/10760296221139258.

Effect of metformin on adverse outcomes in T2DM patients: Systemic review and meta-analysis of observational studies.

Xu Z, Zhang H, Wu C, Zheng Y, Jiang J Front Cardiovasc Med. 2022; 9:944902.

PMID: 36211585 PMC: 9539433. DOI: 10.3389/fcvm.2022.944902.

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