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Table 5 Subgroup analysis of hazard ratios of cardiovascular diseases and hypoglycemic events associated with various antidiabetic drugs, as compared to DPP4i as reference, in the patients without CVD history

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)

MACEs

Antidiabetic drug (ref. = DPP4i)

16,975

17.67

–

–

No antidiabetic drug

57,199

25.84

1.50 (1.29, 1.74)

1.38 (1.19, 1.60)

Sulfonylureas

69,766

17.55

0.99 (0.86, 1.15)

0.93 (0.80, 1.07)

Acarbose

12,828

23.38

1.33 (1.10, 1.60)

1.22 (1.01, 1.47)

Meglitinides

6756

48.10

2.73 (2.28, 3.26)

2.04(1.70, 2.44)

Insulin

5713

98.70

5.56 (4.70, 6.58)

5.48 (4.60, 6.50)

Metformin

105,576

14.65

0.83 (0.72, 0.96)

0.82 (0.70, 0.94)

Pioglitazone

2995

10.35

0.58 (0.39, 0.87)

0.61 (0.40, 0.90)

Rosiglitazone

318

12.56

0.68 (0.25, 1.83)

0.68 (0.25, 1.84)

Ischemic stroke

Antidiabetic drug (ref. = DPP4i)

16,975

9.60

–

–

No antidiabetic drug

57,199

16.11

1.70 (1.38, 2.07)

1.52 (1.23, 1.86)

Sulfonylureas

69,766

11.28

1.17 (0.96, 1.42)

1.04 (0.85, 1.27)

Acarbose

12,828

14.26

1.49 (1.15, 1.92)

1.34 (1.03, 1.74)

Meglitinides

6756

24.27

2.52 (1.96, 3.22)

1.85 (1.44, 2.36)

Insulin

5713

61.08

6.32 (5.02, 7.94)

6.56 (5.21, 8.27)

Metformin

105,576

10.32

1.07 (0.88, 1.29)

1.01 (0.82, 1.22)

Pioglitazone

2995

7.67

0.80 (0.49, 1.29)

0.81 (0.50, 1.32)

Rosiglitazone

318

12.56

1.21 (0.44, 3.27)

1.22 (0.44, 3.32)

Myocardial infarction

Antidiabetic drug (ref. = DPP4i)

16,975

2.82

–

–

No antidiabetic drug

57,199

3.91

1.55 (1.09, 2.20)

1.56 (1.09, 2.22)

Sulfonylureas

69,766

2.39

0.88 (0.63, 1.22)

0.93 (0.66, 1.29)

Acarbose

12,828

2.96

1.08 (0.68, 1.70)

1.09 (0.69, 1.71)

Meglitinides

6756

5.47

2.02 (1.33, 3.04)

1.78 (1.17, 2.69)

Insulin

5713

10.67

3.84 (2.54, 5.79)

3.38 (2.23, 5.10)

Metformin

105,576

1.99

0.74 (0.53, 1.02)

0.81 (0.58, 1.13)

Pioglitazone

2995

1.66

0.59 (0.23, 1.49)

0.63 (0.24, 1.60)

Rosiglitazone

318

0

0

0

Heart failure

Antidiabetic drug (ref. = DPP4i)

16,975

6.18

–

–

No antidiabetic drug

57,199

7.18

1.19 (0.92, 1.52)

1.13 (0.87, 1.45)

Sulfonylureas

69,766

4.61

0.75 (0.58, 0.95)

0.73 (0.57, 0.94)

Acarbose

12,828

7.09

1.15 (0.84, 1.56)

1.06 (0.78, 1.44)

Meglitinides

6756

20.86

3.38 (2.55, 4.46)

2.45 (1.85, 3.22)

Insulin

5713

33.95

5.45 (4.17, 7.10)

4.75(3.54, 6.35)

Metformin

105,576

2.97

0.48 (0.37, 0.61)

0.51 (0.39, 0.65)

Pioglitazone

2995

1.66

0.27 (0.10, 0.66)

0.29 (0.11, 0.71)

Rosiglitazone

318

0

0

0

Hypoglycemia

Antidiabetic drug (ref. = DPP4i)

16,975

4.77

–

–

No antidiabetic drug

57,199

3.63

0.69 (0.51, 0.92)

0.69 (0.51, 0.92)

Sulfonylureas

69,766

3.92

0.76 (0.59, 0.98)

0.78 (0.60, 1.00)

Acarbose

12,828

4.52

0.91 (0.65, 1.24)

0.89 (0.64, 1.22)

Meglitinides

6756

12.58

2.44 (1.70, 3.49)

1.93 (1.33, 2.77)

Insulin

5713

35.17

6.95 (5.17, 9.34)

5.47 (4.00, 7.48)

Metformin

105,576

2.13

0.41 (0.30, 0.55)

0.46 (0.34, 0.61)

Pioglitazone

2995

4.34

0.84 (0.47, 1.50)

0.93 (0.52, 1.65)

Rosiglitazone

318

6.28

0.89 (0.22, 3.57)

0.91 (0.23, 3.56)

  1. CVD cardiovascular disease, HR hazard ratio, CI confidence interval, MACEs major adverse cardiovascular events, DPP-4 inhibitors dipeptidyl peptidase-4 inhibitors
  2. * 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)
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Cardiovascular Diabetology

ISSN: 1475-2840