Abstract
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.
| Original language | English |
|---|---|
| Article number | 28 |
| Journal | Cardiovascular Diabetology |
| Volume | 18 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2019 Mar 11 |
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Keywords
- Cardiocerebrovascular disease
- Dipeptidyl peptidase-4 inhibitors
- End-stage renal disease
- Heart failure
- Sulfonylurea
- Type 2 diabetes
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Cardiology and Cardiovascular Medicine
Cite this
Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin : Cardiovascular and renal outcomes in a propensity-matched cohort study. / Kim, Nam Hoon; 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.
In: Cardiovascular Diabetology, Vol. 18, No. 1, 28, 11.03.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin
T2 - Cardiovascular and renal outcomes in a propensity-matched cohort study
AU - Kim, Nam Hoon
AU - Kim, Kyoung Jin
AU - Choi, Jimi
AU - Lee, Juneyoung
AU - Bae, Jae Hyun
AU - An, Jee Hyun
AU - Kim, Hee Young
AU - Yoo, Hye-Jin
AU - Seo, Ji A
AU - Kim, Nan Hee
AU - Choi, Kyung Mook
AU - Baik, Sei-Hyun
AU - Kim, Sin Gon
PY - 2019/3/11
Y1 - 2019/3/11
N2 - 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.
AB - 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.
KW - Cardiocerebrovascular disease
KW - Dipeptidyl peptidase-4 inhibitors
KW - End-stage renal disease
KW - Heart failure
KW - Sulfonylurea
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85062841930&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062841930&partnerID=8YFLogxK
U2 - 10.1186/s12933-019-0835-z
DO - 10.1186/s12933-019-0835-z
M3 - Article
C2 - 30857540
AN - SCOPUS:85062841930
VL - 18
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
SN - 1475-2840
IS - 1
M1 - 28
ER -