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Original Article
- Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database) - The Effects of Glucose Lowering Agents on the Secondary Prevention of Coronary Artery Disease in Patients with Type 2 Diabetes
- Inha Jung, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Eun-Jung Rhee, Won-Young Lee
- Endocrinol Metab. 2021;36(5):977-987. Published online October 14, 2021
- DOI: https://doi.org/10.3803/EnM.2021.1046
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- 175 Download
- 3 Web of Science
- 3 Crossref
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Abstract
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Supplementary Material
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ePub - 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. -
Citations
Citations to this article as recorded by
- Application of systemic inflammation indices and lipid metabolism-related factors in coronary artery disease
Zhuoyan Zhao, Huan Lian, Yixiang Liu, Lixian Sun, Ying Zhang
Coronary Artery Disease.2023; 34(5): 306. CrossRef - Effect of metformin on adverse outcomes in T2DM patients: Systemic review and meta-analysis of observational studies
Zhicheng Xu, Haidong Zhang, Chenghui Wu, Yuxiang Zheng, Jingzhou Jiang
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef - Establishment of a Predictive Model for Poor Prognosis of Incomplete Revascularization in Patients with Coronary Heart Disease and Multivessel Disease
Huan Lian, Zhuoyan Zhao, Kelin Ma, Zhenjiang Ding, Lixian Sun, Ying Zhang
Clinical and Applied Thrombosis/Hemostasis.2022; 28: 107602962211392. CrossRef
- Application of systemic inflammation indices and lipid metabolism-related factors in coronary artery disease
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