Abstract
Objective: Type 2 Diabetes Mellitus (DM) is associated with an increased risk of cardiovascular events. Glycemic control is beneficial to reduce acute myocardial infarction (AMI), however little is known whether a specific antidiabetic treatment is superior to another. This study aims at examining antidiabetic drugs and their association with a subsequent AMI in patients with DM. Methods: A nested case-control study was conducted. Cases were patients with DM who subsequently suffered from AMI; controls were DM patients with no subsequent AMI after DM diagnosis. Using the Danish National Hospital Discharge Register, we included DM patients with information on date of DM diagnosis, date of AMI, and comorbidities. From the Central Region of Jutland, Denmark, medication use and biochemical parameters were collected. Multivariate logistic regression analyses were conducted. Results: 10,727 DM patients were included. In multivariate analysis liraglutide (OR= 0.386, 95%CI 0.218-0.682) decreased the risk of AMI. An AMI prior to DM diagnosis (OR=36.004, 95%CI: 24.441-53.038), increasing age (1.027, 95%CI 1.016-1.039), increasing diabetes duration (1.060, 95%CI 1.043-1.077), male gender (OR=1.310, 95%CI 1.025-1.676), a diagnosis of heart failure (OR=2.083, 95%CI: 1.459-2.973), and peripheral artery disease (OR=1.506, 95%CI: 1.032-2.198) were all significantly associated with the risk of subsequent AMI. Neither insulin, β- cell stimulans, biguanides, antihypertensive treatment nor usage of statins or antiarrhythmic drugs showed any significance. When additional adjustment by biochemical risk markers was done insulin was significantly associated with a reduced risk of AMI (OR=0.235, 95%CI 0.073-0.757). .Furthermore, liraglutide and biguanides both showed a significant dose- and exposure time effects on OR for AMI. Conclusion: We have found a strong association between the use of liraglutide and insulin, and a reduced risk of AMI in patients with DM when taking general risk factors into account.
Highlights
The strong correlation between type 2 diabetes mellitus (DM) and cardiovascular morbidity and mortality is well established [1]
We have found a strong association between the use of liraglutide and insulin, and a reduced risk of acute myocardial infarction (AMI) in patients with DM when taking general risk factors into account
The aim of this study is to investigate whether a specific antidiabetic therapy is superior to other antidiabetic therapies in prevention of the first Acute Myocardial Infarction (AMI) in DM patients
Summary
The strong correlation between type 2 diabetes mellitus (DM) and cardiovascular morbidity and mortality is well established [1]. Combined guidelines from the American Heart Association (AHA) and the American Diabetes Association (ADA) suggests, in addition to lifestyle changes, to control risk factors by medical treatment of dyslipidemia, hypertension, coagulation and hyperglycemia as primary prevention of cardiovascular diseases in patients with DM [4]. A meta-analysis of five randomized controlled trials found a beneficial effect of intensive glycemic control and concomitant lower HbA1c on cardiovascular disease (CVD), with a pooled reduction of 17% on myocardial infarction among DM patients [5].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
