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Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study

BACKGROUND: To determine the impact of dipeptidyl peptidase-4 inhibitor (DPP4i) on the risk of major cardiocerebrovascular and renal outcomes compared with sulfonylurea (SU) combined with metformin in patients with type 2 diabetes from a population-based cohort. METHODS: From a nationwide cohort in...

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Autores principales: Kim, Kyoung Jin, Choi, Jimi, Lee, Juneyoung, Bae, Jae Hyun, An, Jee Hyun, Kim, Hee Young, Yoo, Hye Jin, Seo, Ji A., Kim, Nan Hee, Choi, Kyung Mook, Baik, Sei Hyun, Kim, Sin Gon, Kim, Nam Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410523/
https://www.ncbi.nlm.nih.gov/pubmed/30857540
http://dx.doi.org/10.1186/s12933-019-0835-z
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author Kim, Kyoung Jin
Choi, Jimi
Lee, Juneyoung
Bae, Jae Hyun
An, Jee Hyun
Kim, Hee Young
Yoo, Hye Jin
Seo, Ji A.
Kim, Nan Hee
Choi, Kyung Mook
Baik, Sei Hyun
Kim, Sin Gon
Kim, Nam Hoon
author_facet Kim, Kyoung Jin
Choi, Jimi
Lee, Juneyoung
Bae, Jae Hyun
An, Jee Hyun
Kim, Hee Young
Yoo, Hye Jin
Seo, Ji A.
Kim, Nan Hee
Choi, Kyung Mook
Baik, Sei Hyun
Kim, Sin Gon
Kim, Nam Hoon
author_sort Kim, Kyoung Jin
collection PubMed
description BACKGROUND: To determine the impact of dipeptidyl peptidase-4 inhibitor (DPP4i) on the risk of major cardiocerebrovascular and renal outcomes compared with sulfonylurea (SU) combined with metformin in patients with type 2 diabetes from a population-based cohort. METHODS: From a nationwide cohort in Korea (2008–2013), 23,674 patients with type 2 diabetes treated with DPP4i plus metformin or SU plus metformin were selected and matched by propensity score. Composite cardiocerebrovascular events including incident ischemic heart disease (IHD), ischemic stroke (IS), hospitalization for heart failure (HHF), and cardiocerebrovascular death, as well as renal events including incident end-stage renal disease or initiation of renal-replacement therapy were assessed by Cox proportional-hazards models. RESULTS: During a median follow-up of 19.6 months (interquartile range 7.2–36.4), 762 composite cardiocerebrovascular events and 17 end-stage renal events occurred. There was no significant difference in the risk of IHD (hazard ratio [HR], 1.00; 95% CI 0.81–1.23), IS (HR, 0.95; 95% CI 0.74–1.23), or cardiocerebrovascular death (HR, 0.74; 95% CI 0.46–1.18) in the DPP4i group compared to that in the SU group. Likewise, DPP4i therapy was not associated with the risk of end-stage renal outcomes (HR, 1.23; 95% CI 0.41–3.62). However, the risk of HHF was significantly higher in the DPP4i group than in the SU group (HR, 1.47; 95% CI 1.07–2.04). CONCLUSIONS: This real-world database analysis showed that DPP4i therapy did not increase the overall risk of major cardiovascular and renal outcomes compared to SU therapy. However, the DPP4i-associated risk of HHF remained significant. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12933-019-0835-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-64105232019-03-21 Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study Kim, Kyoung Jin Choi, Jimi Lee, Juneyoung Bae, Jae Hyun An, Jee Hyun Kim, Hee Young Yoo, Hye Jin Seo, Ji A. Kim, Nan Hee Choi, Kyung Mook Baik, Sei Hyun Kim, Sin Gon Kim, Nam Hoon Cardiovasc Diabetol Original Investigation BACKGROUND: To determine the impact of dipeptidyl peptidase-4 inhibitor (DPP4i) on the risk of major cardiocerebrovascular and renal outcomes compared with sulfonylurea (SU) combined with metformin in patients with type 2 diabetes from a population-based cohort. METHODS: From a nationwide cohort in Korea (2008–2013), 23,674 patients with type 2 diabetes treated with DPP4i plus metformin or SU plus metformin were selected and matched by propensity score. Composite cardiocerebrovascular events including incident ischemic heart disease (IHD), ischemic stroke (IS), hospitalization for heart failure (HHF), and cardiocerebrovascular death, as well as renal events including incident end-stage renal disease or initiation of renal-replacement therapy were assessed by Cox proportional-hazards models. RESULTS: During a median follow-up of 19.6 months (interquartile range 7.2–36.4), 762 composite cardiocerebrovascular events and 17 end-stage renal events occurred. There was no significant difference in the risk of IHD (hazard ratio [HR], 1.00; 95% CI 0.81–1.23), IS (HR, 0.95; 95% CI 0.74–1.23), or cardiocerebrovascular death (HR, 0.74; 95% CI 0.46–1.18) in the DPP4i group compared to that in the SU group. Likewise, DPP4i therapy was not associated with the risk of end-stage renal outcomes (HR, 1.23; 95% CI 0.41–3.62). However, the risk of HHF was significantly higher in the DPP4i group than in the SU group (HR, 1.47; 95% CI 1.07–2.04). CONCLUSIONS: This real-world database analysis showed that DPP4i therapy did not increase the overall risk of major cardiovascular and renal outcomes compared to SU therapy. However, the DPP4i-associated risk of HHF remained significant. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12933-019-0835-z) contains supplementary material, which is available to authorized users. BioMed Central 2019-03-11 /pmc/articles/PMC6410523/ /pubmed/30857540 http://dx.doi.org/10.1186/s12933-019-0835-z Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Investigation
Kim, Kyoung Jin
Choi, Jimi
Lee, Juneyoung
Bae, Jae Hyun
An, Jee Hyun
Kim, Hee Young
Yoo, Hye Jin
Seo, Ji A.
Kim, Nan Hee
Choi, Kyung Mook
Baik, Sei Hyun
Kim, Sin Gon
Kim, Nam Hoon
Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study
title Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study
title_full Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study
title_fullStr Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study
title_full_unstemmed Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study
title_short Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study
title_sort dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410523/
https://www.ncbi.nlm.nih.gov/pubmed/30857540
http://dx.doi.org/10.1186/s12933-019-0835-z
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