https://scholars.lib.ntu.edu.tw/handle/123456789/587692
標題: | Metformin was associated with lower all-cause mortality in type 2 diabetes with acute coronary syndrome: A Nationwide registry with propensity score-matched analysis | 作者: | CHIEN-BOON JONG Chen K.-Y. MU-YANG HSIEH Su F.-Y. CHIH-CHENG WU Voon W.-C. Hsieh I.-C. Shyu K.-G. Chong J.-T. Lin W.-S. Hsu C.-N. Ueng K.-C. CHAO LUN LAI |
公開日期: | 2019 | 出版社: | Elsevier Ireland Ltd | 卷: | 291 | 起(迄)頁: | 152-157 | 來源出版物: | International Journal of Cardiology | 摘要: | Background: No randomized controlled trials evaluating metformin therapy efficacy in patients with type 2 diabetes mellitus (DM) and acute coronary syndrome (ACS) have been reported. We aimed to examine the mortality benefit of metformin therapy in patients with type 2 DM and ACS, compared with non-metformin anti-diabetes agents users. Methods: Data were extracted from the prospective nationwide ACS-DM Taiwan Society of Cardiology registry. Propensity score (PS) matching on baseline characteristics and treatment measures was performed for metformin versus non-metformin users. The Cox proportional hazards model was used to compare mortality outcomes among the PS-matched cohort as the primary analysis. The Cox proportional hazards models adjusting for all pre-determined covariates and quintiles of the PS among the overall population were performed as the secondary analyses. Results: Of 1157 patients with type 2 DM and ACS receiving anti-diabetes agents, 78 patients (6.7%) died over the 2-year follow-up period. After PS matching, 318 metformin users were matched with 318 non-metformin users. Metformin users had a lower all-cause mortality rate (adjusted hazard ratio [aHR] 0.50, 95% confidence interval [CI] 0.26–0.95) in the primary analysis. The survival benefit of metformin therapy was consistent in the secondary analyses (aHR 0.30, 95% CI 0.17–0.54 while adjusting for all pre-determined covariates, and aHR 0.34, 95% CI 0.19–0.59 while adjusting for quintiles of the PS). Conclusions: Among patients with type 2 DM and ACS, metformin was associated with lower all-cause mortality. However, a detrimental effect of any of the comparators could not be excluded. ? 2019 Elsevier B.V. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85063093339&doi=10.1016%2fj.ijcard.2019.03.021&partnerID=40&md5=cef7a0fb6a475aa9826b8d1f9e7ae5dc https://scholars.lib.ntu.edu.tw/handle/123456789/587692 |
ISSN: | 0167-5273 | DOI: | 10.1016/j.ijcard.2019.03.021 | SDG/關鍵字: | angiotensin receptor antagonist; antithrombocytic agent; beta adrenergic receptor blocking agent; dipeptidyl carboxypeptidase inhibitor; hydroxymethylglutaryl coenzyme A reductase inhibitor; inotropic agent; insulin; metformin; oral antidiabetic agent; antidiabetic agent; metformin; acute coronary syndrome; adult; all cause mortality; Article; cardiology; clinical feature; clinical outcome; cohort analysis; controlled study; disease registry; drug efficacy; female; follow up; human; major clinical study; male; medical society; monotherapy; mortality; mortality rate; non insulin dependent diabetes mellitus; outcome assessment; priority journal; propensity score; Taiwan; treatment response; acute coronary syndrome; aged; epidemiology; middle aged; non insulin dependent diabetes mellitus; propensity score; prospective study; register; retrospective study; risk factor; very elderly; Acute Coronary Syndrome; Aged; Aged, 80 and over; Diabetes Mellitus, Type 2; Female; Humans; Hypoglycemic Agents; Male; Metformin; Middle Aged; Mortality; Propensity Score; Prospective Studies; Registries; Retrospective Studies; Risk Factors; Taiwan |
顯示於: | 醫學系 |
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