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.