The Effects of Glucose Lowering Agents on the Secondary Prevention of Coronary Artery Disease in Patients with Type 2 Diabetesopen access
- Authors
- Jung, Inha; Kwon, Hyemi; Park, Se Eun; Han, Kyung-Do; Park, Yong-Gyu; Rhee, Eun-Jung; Lee, Won-Young
- Issue Date
- Oct-2021
- Publisher
- KOREAN ENDOCRINE SOC
- Keywords
- Diabetes mellitus; Coronary artery disease; Secondary prevention; Percutaneous coronary intervention
- Citation
- Endocrinology and Metabolism, v.36, no.5, pp 977 - 987
- Pages
- 11
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Endocrinology and Metabolism
- Volume
- 36
- Number
- 5
- Start Page
- 977
- End Page
- 987
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63234
- DOI
- 10.3803/EnM.2021.1046
- ISSN
- 2093-596X
2093-5978
- 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/m(2), 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 metfonnin 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.
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Collections - 2. Clinical Science > Department of Endocrinology and Metabolism > 1. Journal Articles
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