RT Journal Article SR Electronic T1 Effects of Metformin Versus Glipizide on Cardiovascular Outcomes in Patients With Type 2 Diabetes and Coronary Artery Disease JF Diabetes Care JO Diabetes Care FD American Diabetes Association SP 1304 OP 1311 DO 10.2337/dc12-0719 VO 36 IS 5 A1 Hong, Jie A1 Zhang, Yifei A1 Lai, Shenghan A1 Lv, Ankang A1 Su, Qing A1 Dong, Yan A1 Zhou, Zhiguang A1 Tang, Weili A1 Zhao, Jiajun A1 Cui, Lianqun A1 Zou, Dajin A1 Wang, Dawang A1 Li, Hong A1 Liu, Chao A1 Wu, Guoting A1 Shen, Jie A1 Zhu, Dalong A1 Wang, Weiqing A1 Shen, Weifeng A1 Ning, Guang A1 , YR 2013 UL http://care.diabetesjournals.org/content/36/5/1304.abstract AB OBJECTIVE The two major classes of antidiabetic drugs, sulfonylureas and metformin, may differentially affect macrovascular complications and mortality in diabetic patients. We compared the long-term effects of glipizide and metformin on the major cardiovascular events in type 2 diabetic patients who had a history of coronary artery disease (CAD).RESEARCH DESIGN AND METHODS This study is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 304 type 2 diabetic patients with CAD, mean age = 63.3 years (range, 36–80 years), were enrolled. Participants were randomly assigned to receive either glipizide (30 mg daily) or metformin (1.5 g daily) for 3 years. The primary end points were times to the composite of recurrent cardiovascular events, including death from a cardiovascular cause, death from any cause, nonfatal myocardial infarction, nonfatal stroke, or arterial revascularization.RESULTS At the end of study drug administration, both groups achieved a significant decrease in the level of glycated hemoglobin (7.1% in the glipizide group and 7.0% in the metformin group). At a median follow-up of 5.0 years, 91 participants had developed 103 primary end points. Intention-to-treat analysis showed an adjusted hazard ratio (HR) of 0.54 (95% CI 0.30–0.90; P = 0.026) for the composites of cardiovascular events among the patients that received metformin, compared with glipizide. The secondary end points and adverse events were not significantly different between the two groups.CONCLUSIONS Treatment with metformin for 3 years substantially reduced major cardiovascular events in a median follow-up of 5.0 years compared with glipizide. Our results indicated a potential benefit of metformin therapy on cardiovascular outcomes in high-risk patients.