國家衛生研究院 NHRI:Item 3990099045/9405

NHRI > National Institute of Infectious Diseases and Vaccinology > Shu-Chen Kuo > Periodical Articles > Item 3990099045/9405

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Title:	Cardiovascular outcomes of dipeptidyl peptidase-4 inhibitors in elderly patients with type 2 diabetes: A nationwide study
Authors:	Shih, CJ;Chen, HT;Kuo, SC;Ou, SM;Chen, YT
Contributors:	Division of Infectious Diseases
Abstract:	OBJECTIVES: The elderly (aged >/=65 years) population with type 2 diabetes (T2D) is growing substantially, but evidence for associations between the use of dipeptidyl peptidase-4 inhibitors (DPP-4is), novel incretin-based antidiabetic drugs, and clinical hard endpoints in this group remains inconclusive. We aimed to assess the safety and cardiovascular effects of DPP-4i use in a nationally representative sample of elderly adults with T2D. DESIGN, SETTING, AND PARTICIPANTS: We conducted a nationwide, observational, propensity score-matched study using Taiwan's National Health Insurance Research Database. Of a total of 414,213 patients aged >/=65 years with T2D, 58,485 patients receiving initial DPP-4i prescriptions between March 1, 2009, and June 31, 2013, were included. Each DPP-4i user was matched with a nonuser control using propensity scores. The endpoints were all-cause mortality and major adverse cardiovascular events (MACEs), including ischemic stroke and myocardial infarction. Potential adverse effects of hospitalization for heart failure and hypoglycemia were also evaluated. RESULTS: Compared with the matched control cohort, the risks of all-cause mortality (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.52-0.56), MACEs (HR 0.79, 95% CI 0.75-0.83), myocardial infarction (HR 0.79, 95% CI 0.72-0.87), and ischemic stroke (HR 0.79, 95% CI 0.75-0.84) were lower in the DPP-4i cohort. DPP-4i use did not affect the risks of hospitalization for heart failure and hypoglycemia. Stratified analyses produced consistent results across age, sex, and comorbidity subgroups. CONCLUSIONS: Prescription of DPP-4is was associated with reduced risks of all-cause mortality and MACEs in patients aged >/=65 years with T2D.
Date:	2016-01
Relation:	Journal of the American Medical Directors Association. 2016 Jan;17(1):59-64.
Link to:	http://dx.doi.org/10.1016/j.jamda.2015.10.009
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1525-8610&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000366756400013
Cited Times(Scopus):	http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84955171790
Appears in Collections:	[Shu-Chen Kuo] Periodical Articles

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