Dipeptidyl peptidase-4 inhibitors do not increase the risk of cardiovascular events in type 2 diabetes: a cohort study.
Dipeptidyl peptidase-4 inhibitors do not increase the risk of cardiovascular events in type 2 diabetes: a cohort study.
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DOI：
10.1007/s00592-014-0663-2
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发表时间：
2014-12
影响因子：
3.8
通讯作者：
Goldfine, Allison B.
中科院分区：
文献类型：
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作者：
Kim, Seoyoung C.;Glynn, Robert J.;Liu, Jun;Everett, Brendan M.;Goldfine, Allison B.
最近在有心血管疾病（CVD）病史或心血管疾病（CVD）高危的2型糖尿病（T2 DM）患者中开展的两项随机对照试验显示，二肽基肽酶-4抑制剂（DPP 4 i）没有缺血性心血管事件风险，但沙格列汀可增加心力衰竭（HF）风险。我们评价了社区中基线时有和无心血管疾病（CVD）的T2 DM患者中与DPP 4 i相关的心血管疾病（CVD）风险，包括心肌梗死（MI）、卒中、冠状动脉血运重建和HF。使用美国商业保险索赔数据（2005-2012年），我们进行了一项队列研究，包括DPP 4 i和非DPP 4 i治疗的启动者。使用出院诊断或手术代码定义复合CVD终点，包括MI、卒中、冠状动脉血运重建和HF。考克斯比例风险模型比较了倾向评分（PS）匹配的DPP 4与非DPP 4 i启动者的复合和个体CVD终点风险。我们纳入了79，538名（18%基线CVD）患者，这些患者在PS匹配的DPP 4 i和非DPP 4 i启动者对中。DPP 4 i组和非DPP 4 i组复合CVD的发病率分别为30.30（95%CI 28.24-32.51）和34.76（95%CI 32.34-37.36）/1,000人-年。DPP 4 i组与非DPP 4 i组复合CVD的PS匹配风险比（HR）为0.87（95%CI 0.79-0.96）。DPP 4 i组与非DPP 4 i组相比，HF的PS匹配HR为0.81（95%CI 0.70-0.94）。在基线CVD患者中，使用DPP 4 i不会增加CVD或HF的风险。在T2 DM患者中，与非DPP 4 i启动者相比，启动DPP 4 i与CVD或HF风险增加无关。
Two recent randomized controlled trials of type 2 diabetes mellitus (T2DM) patients with history of, or at high risk for, cardiovascular disease (CVD) showed no risk of ischemic cardiovascular events associated with dipeptidyl peptidase-4 inhibitors (DPP4i) but an increased risk of heart failure (HF) with saxagliptin. We evaluated the risk of cardiovascular disease (CVD) including myocardial infarction (MI), stroke, coronary revascularization, and HF associated with DPP4i in T2DM patients with and without baseline CVD as used in the community. Using US commercial insurance claims data (2005–2012), we conducted a cohort study that included initiators of DPP4i and non-DPP4i treatment. Composite CVD endpoints including MI, stroke, coronary revascularization and HF, were defined with a hospital discharge diagnosis or procedure code. Cox proportional hazards models compared the risk of composite and individual CVD endpoints in propensity score (PS) matched initiators of DPP4 vs. non-DPP4i. We included 79,538 (18% with baseline CVD) persons in PS-matched pairs of DPP4i and non-DPP4i initiators. The incidence rate per 1,000 person-years for composite CVD was 30.30 (95%CI 28.24–32.51) in DPP4i and 34.76 (95%CI 32.34–37.36) in non-DPP4i. The PS-matched hazard ratio (HR) for composite CVD was 0.87 (95%CI 0.79–0.96) in DPP4i vs. non-DPP4i. The PS-matched HR for HF was 0.81 (95%CI 0.70–0.94) in DPP4i vs. non-DPP4i. Among patients with baseline CVD, there was no increased risk for CVD or HF associated with DPP4i use. Among T2DM patients initiating DPP4i was not associated with a greater risk of CVD or HF compared to non-DPP4i initiators.
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DOI：
10.1136/bmj.g2366
发表时间：
2014-04-15
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Li L;Shen J;Bala MM;Busse JW;Ebrahim S;Vandvik PO;Rios LP;Malaga G;Wong E;Sohani Z;Guyatt GH;Sun X
通讯作者：
Sun X
影响因子：
158.5
作者：
Scirica, Benjamin M.;Bhatt, Deepak L.;Simmons, D.
通讯作者：
Simmons, D.
DOI：
10.7326/0003-4819-127-8_part_2-199710151-00064
发表时间：
1997-10-15
影响因子：
39.2
作者：
Rubin, DB
通讯作者：
Rubin, DB
影响因子：
4.8
作者：
Kiyota, Y;Schneeweiss, S;Solomon, DH
通讯作者：
Solomon, DH
影响因子：
2.6
作者：
Andrade, Susan E.;Harrold, Leslie R.;Tjia, Jennifer;Cutrona, Sarah L.;Saczynski, Jane S.;Dodd, Katherine S.;Goldberg, Robert J.;Gurwitz, Jerry H.
通讯作者：
Gurwitz, Jerry H.