Cardiovascular Diabetology | |
Dipeptidyl peptidase-4 inhibitor decreases the risk of atrial fibrillation in patients with type 2 diabetes: a nationwide cohort study in Taiwan | |
Original Investigation | |
Chia-Yu Chang1  Yung-Hsin Yeh2  Shang-Hung Chang2  Hsin-Fu Lee2  Chi-Tai Kuo2  Lung-Sheng Wu2  Kun-Chi Yen2  Yi-Hsin Chan3  Jia-Rou Liu4  Lai-Chu See5  | |
[1] College of Medicine, Chang Gung University, 33302, Taoyuan, Taiwan;College of Medicine, Chang Gung University, 33302, Taoyuan, Taiwan;Department of Cardiology, Chang Gung Memorial Hospital, Linkou, 33305, Taoyuan, Taiwan;College of Medicine, Chang Gung University, 33302, Taoyuan, Taiwan;Department of Cardiology, Chang Gung Memorial Hospital, Linkou, 33305, Taoyuan, Taiwan;Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, 33305, Taoyuan, Taiwan;Department of Public Health, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan, 33302, Taoyuan, Taiwan;Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, 33302, Taoyuan, Taiwan;Department of Public Health, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan, 33302, Taoyuan, Taiwan;Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, 33302, Taoyuan, Taiwan;Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Linkou, 33305, Taoyuan, Taiwan; | |
关键词: Dipeptidyl peptidase-4 inhibitor; Type 2 diabetes mellitus; Atrial fibrillation; | |
DOI : 10.1186/s12933-017-0640-5 | |
received in 2017-09-01, accepted in 2017-12-06, 发布年份 2017 | |
来源: Springer | |
【 摘 要 】
BackgroundWhether dipeptidyl peptidase-4 inhibitor (DPP4i) is associated with a lower risk of new-onset atrial fibrillation (AF) in patients with diabetes remains unclear. This study aimed to evaluate the risk of AF associated with use of DPP4i among a longitudinal cohort of patients with diabetes.MethodsOver a 3-year period, 480,000 patients with diabetes were analyzed utilizing Taiwan’s National Health Insurance Research Database and 90,880 patients taking metformin as first-line therapy were enrolled. Patients were further divided into two groups: (1) DPP4i users: those taking DPP4i and (2) non-DPP4i users: those prescribed other hypoglycemic agents (HAs) as second-line drug. Study end point was defined by diagnosis of AF, addition of any third-line HA, or the end of the study period (December 31, 2013), whichever came first.ResultsA total of 16,017 DPP4i users and 74,863 non-DPP4i users were eligible for the study. For the DPP4i group, most patients were prescribed sitagliptin (n = 12,180; 76%). Among the non-DPP4i group, most patients took sulfonylurea (n = 60,606; 81%) as their second-line medication. DPP4i users were associated with a lower risk of new-onset AF compared with non-DPP4i users after propensity-score weighting (hazard ratio 0.65; P < 0.0001). Subgroup analysis showed that DPP4i user were associated with a lower risk of new-onset AF compared with non-DPP4i users in most subgroups. Multivariate analysis indicated that use of DPP4i was associated with lower risk of new-onset AF and age > 65 years, presence of hypertension, and ischemic heart disease were independent risk factors for new-onset AF.ConclusionsAmong patients with diabetes prescribed with metformin, the patients with DPP4i as second HA were associated with a lower risk of AF compared with the patients with other drugs as second HAs in real-world practice.
【 授权许可】
CC BY
© The Author(s) 2017
【 预 览 】
Files | Size | Format | View |
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RO202311103775318ZK.pdf | 1083KB | download |
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