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Dipeptidyl Peptidase-4 Inhibitors And Cardiovascular Risk.
MedLine Citation:
PMID:  22925682     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: Preliminary data from randomized trials with metabolic outcomes have shown that treatment with dipeptidyl peptidase-4 inhibitors (DPP4i) could be associated with a reduced incidence of major cardiovascular events (MACE). The present meta-analysis is aimed at verifying this protective effect, collecting all available data from randomized trials. MATERIALS AND METHODS: A comprehensive search for published and unpublished trials with a duration ≥24 weeks comparing DPP4i with placebo or other drugs was performed, retrieving all MACE reported as serious adverse events together with death from any cause. Mantel-Haenzel Odds Ratio (MH-OR) was calculated with random effect models for MACE, myocardial infarction, stroke, and mortality. When available, effects on glycated haemoglobin, lipid profile, and blood pressure were also assessed and used for the estimation of the modification of risk for myocardial infarction using the UKPDS risk engine. RESULTS: A total of 70 trials, enrolling 41,959 patients with a mean follow-up of 44.1 weeks, was collected and included in the analysis. The MH-OR [95% Confidence Interval] was 0.71[0.59;0.86], 0.64[0.44;0.94], 0.77[0.48;1.24], and 0.60[0.41;0.88] for MACE, myocardial infarction, stroke, and mortality, respectively. CONCLUSIONS: treatment with DPP4i reduces the risk of cardiovascular events (particularly myocardial infarction) and all-cause mortality in patients with type 2 diabetes. The reduction in the incidence of myocardial infarction is greater than what predicted on the basis of conventional risk factors, suggesting a role for other mechanisms.
Authors:
Matteo Monami; Bo Ahren; Ilaria Dicembrini; Edoardo Mannucci
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-23
Journal Detail:
Title:  Diabetes, obesity & metabolism     Volume:  -     ISSN:  1463-1326     ISO Abbreviation:  Diabetes Obes Metab     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883645     Medline TA:  Diabetes Obes Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Section of Geriatric Cardiology and Medicine, Careggi Teaching Hospital.
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