Dipeptidyl peptidase-4 inhibitors versus sulfonylureas on the top of metformin in patients with diabetes and acute myocardial infarction
Why the study?
Glycated hemoglobin reduction extent and glycemic control duration affect cardiovascular outcomes, motivating investigation into how metformin plus DPP4 inhibitors versus sulfonylureas impacts long-term clinical outcomes in AMI patients with type 2 DM.
Does metformin combined with DPP4 inhibitors reduce major adverse cardiac events compared to metformin combined with sulfonylureas in patients with acute myocardial infarction and type 2 diabetes mellitus?
Population
13,104 consecutively enrolled AMI patients with type 2 DM
Comparison
MET + DPP4 inhibitors vs MET + SU
Design
Prospective cohort trial
Follow-up
Up to 3-year follow-up
Authors
Discussion
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Member takes
Overview
MET plus DPP4 inhibitors was associated with fewer recurrent MIs than plus sulfonylureas in AMI with diabetes; leaves open need for randomized confirmation.
Structured PICO
Does metformin combined with DPP4 inhibitors reduce major adverse cardiac events compared to metformin combined with sulfonylureas in patients with acute myocardial infarction and type 2 diabetes mellitus?
P
Population
13,104 patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (DM) consecutively enrolled from the Korea AMI registry-National Institutes of Health.
I
Intervention
Metformin combined with dipeptidyl peptidase-4 (DPP4) inhibitors
C
Comparator
Metformin combined with sulfonylureas (SU)
O
Outcome
Major adverse cardiac events (MACE), defined as the composite of all-cause death, recurrent myocardial infarction (MI), and any repeat revascularization up to 3-year follow-upcomposite
In patients with AMI and type 2 diabetes, adding a DPP4 inhibitor to metformin did not significantly reduce 3-year MACE compared to adding a sulfonylurea, but was associated with a significantly lower risk of recurrent myocardial infarction.
Cite This Study
Her et al. (2024) studied this question.