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Table 3 Hazard ratios of cardiovascular diseases and hypoglycemic events associated with various antidiabetic drugs, as compared to DPP4i as reference

From: Risks of cardiovascular diseases associated with dipeptidyl peptidase-4 inhibitors and other antidiabetic drugs in patients with type 2 diabetes: a nation-wide longitudinal study

  Time at risk (person-years) Incidence rate (per 1000 person-years) Unadjusted HR (95 % CI) Adjusted HR* (95 % CI) p value
MACEs
Antidiabetic drug (ref. = DPP4i) 28,508 39.56
No antidiabetic drug 101,166 62.02 1.52 (1.39, 1.65) 1.31 (1.20, 1.43) <0.0001
Sulfonylureas 110,618 35.99 0.89 (0.81, 0.96) 0.96 (0.88, 1.05) 0.3942
Acarbose 22,800 48.37 1.20 (1.08, 1.33) 1.07 (0.96, 1.18) 0.2098
Meglitinides 13,103 102.49 2.52 (2.27, 2.78) 1.68 (1.52, 1.86) <0.0001
Insulin 9632 206.06 5.08 (4.60, 5.61) 3.73 (3.35, 4.14) <0.0001
Metformin 172,813 30.87 0.76 (0.69, 0.82) 0.87 (0.79, 0.94) 0.0009
Pioglitazone 4678 24.15 0.59 (0.47, 0.73) 0.70 (0.56, 0.86) 0.0011
Rosiglitazone 504 35.64 0.78 (0.48, 1.23) 0.89 (0.55, 1.42) 0.6296
Ischemic stroke
Antidiabetic drug (ref. = DPP4i) 28,508 20.69
No antidiabetic drug 101,166 35.83 1.68 (1.49, 1.89) 1.42 (1.26, 1.60) <0.0001
Sulfonylureas 110,618 21.95 1.03 (0.92, 1.16) 1.06 (0.94, 1.19) 0.3465
Acarbose 22,800 26.18 1.24 (1.08, 1.43) 1.09 (0.94, 1.25) 0.2432
Meglitinides 13,103 50.98 2.39 (2.07, 2.75) 1.58 (1.37, 1.81) <0.0001
Insulin 9632 111.07 5.23 (4.58, 5.97) 3.99 (3.47, 4.56) <0.0001
Metformin 172,813 20.61 0.97 (0.86, 1.08) 1.03 (0.92, 1.15) 0.5630
Pioglitazone 4678 13.25 0.62 (0.47, 0.82) 0.71 (0.53, 0.94) 0.0166
Rosiglitazone 504 23.76 0.99 (0.55, 1.75) 1.06 (0.59, 1.87) 0.8551
Myocardial infarction
Antidiabetic drug (ref. = DPP4i) 28,508 5.19
No antidiabetic drug 101,166 7.01 1.47 (1.20, 1.80) 1.45 (1.18, 1.78) 0.0003
Sulfonylureas 110,618 4.21 0.83 (0.68, 1.01) 0.98 (0.80, 1.78) 0.8257
Acarbose 22,800 5.08 1.00 (0.77, 1.29) 0.98 (0.75, 1.27) 0.8993
Meglitinides 13,103 9.53 1.89 (1.49, 2.39) 1.49 (1.17, 1.90) 0.0011
Insulin 9632 17.64 3.43 (2.72, 4.33) 2.77 (2.17, 3.51) <0.0001
Metformin 172,813 3.30 0.66 (0.54, 0.79) 0.80 (0.50, 1.39) 0.0234
Pioglitazone 4678 3.63 0.70 (0.42, 1.16) 0.84 (0.50, 1.39) 0.5007
Rosiglitazone 504 3.96 0.81 (0.20, 3.23) 0.92 (0.23, 3.63) 0.9037
Heart failure
Antidiabetic drug (ref. = DPP4i) 28,508 15.92
No antidiabetic drug 101,166 25.23 1.50 (1.30, 1.71) 1.28 (1.11, 1.47) 0.0004
Sulfonylureas 110,618 11.78 0.71 (0.62, 0.81) 0.86 (0.74, 1.08) 0.0322
Acarbose 22,800 19.82 1.21 (1.03, 1.42) 1.08 (0.92, 1.26) 0.3227
Meglitinides 13,103 48.23 2.91 (2.48, 3.40) 1.85 (1.58, 2.16) <0.0001
Insulin 9632 92.80 5.67 (4.87, 6.58) 3.71 (3.14, 4.37) <0.0001
Metformin 172,813 8.51 0.51 (0.44, 0.59) 0.66 (0.57, 0.75) <0.0001
Pioglitazone 4678 9.40 0.57 (0.39, 0.80) 0.76 (0.53, 1.07) 0.1229
Rosiglitazone 504 7.92 0.42 (0.15, 1.13) 0.53 (0.19, 1.46) 0.2226
Hypoglycemia
Antidiabetic drug (ref. = DPP4i) 28,508 5.82
No antidiabetic drug 101,166 5.23 0.83 (0.67, 1.00) 0.76 (0.62, 0.92) 0.0053
Sulfonylureas 110,618 6.21 1.00 (0.84, 1.19) 1.08 (0.91, 1.29) 0.3621
Acarbose 22,800 5.83 0.96 (0.77, 1.19) 0.90 (0.72, 1.11) 0.3402
Meglitinides 13,103 18.16 2.91 (2.35, 3.59) 2.09 (1.68, 2.58) <0.0001
Insulin 9632 39.44 6.41 (5.24, 7.84) 4.55 (3.67, 5.64) <0.0001
Metformin 172,813 2.69 0.43 (0.35, 0.52) 0.50 (0.41, 0.60) <0.0001
Pioglitazone 4678 5.77 0.93 (0.62, 1.40) 1.07 (0.71, 1.60) 0.7471
Rosiglitazone 504 11.88 1.50 (0.66, 3.37) 1.58 (0.70, 3.55) 0.2679
  1. The results in italics above indicate significant findings in the Cox models
  2. HR hazard ratio, CI confidence interval, MACEs major adverse cardiovascular events, DPP4i dipeptidyl peptidase-4 inhibitors
  3. * Adjusted hazard ratios were estimated from the Cox models adjusted for age, sex, diabetes duration, comorbidity history (hypertension, hyperlipidemia, coronary artery diseases, stroke, myocardial infarction, heart failure, Charlson comorbidity index), diabetic complications (via adapted diabetic complication severity index), co-medications (α-blockers, β-blockers, diuretics, calcium channel blockers, angiotensin-II-converting enzyme inhibitors/angiotensin receptor blockers, lipid-lowering agents, anti-platelet agents/anticoagulants, nitroglycerin, digoxin)