File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Conference Paper: Triple Therapy with Dpp4 Inhibitor, Insulin, or Thiazolidinediones and Risks of Cardiovascular Diseases and All-Cause Mortality in Patients with Failed Metformin-SU Therapy

TitleTriple Therapy with Dpp4 Inhibitor, Insulin, or Thiazolidinediones and Risks of Cardiovascular Diseases and All-Cause Mortality in Patients with Failed Metformin-SU Therapy
Authors
Issue Date2019
PublisherLippincott Williams & Wilkins, Ltd. The Journal's web site is located at http://www.jhypertension.com/
Citation
29th European Meeting on Hypertension and Cardiovascular Protection (ESH 2019), Milan, Italy, 21-24 June 2019. ESH 2019 Abstract Book in Journal of Hypertension, 2019, v. 37 n. Suppl. 1, p. e309-e310 How to Cite?
AbstractObjective: To examine risks of all-cause mortality, cardiovascular (CV) diseases and severe hypoglycaemia (SH) in patients with diabetes who were intensified with dipeptidylpeptidase-4 (DPP4) inhibitors, insulin, or Thiazolidinediones (TZDs) following metformin-sulfonylurea dual therapy failure. Design and method: We assembled a retrospective cohort data of 17,494 patients who were free of CV diseases, failed to metformin-sulfonylurea dual therapy, and were intensified with DPP4 inhibitors (n = 8,281), insulin (n = 6,559), or TZD (n = 2,654) from January 1, 2006 to January 31, 2018. Propensity-score (PS) weighting was used to balance out baseline covariates across the three groups. Hazard ratios (HRs) for all-cause mortality, CV diseases and SH were assessed using Cox proportional hazard models. Results: Over a mean follow-up period of 34 months with 50,188 person-years, cumulative incidences of all-cause mortality, CVD and SH were 0.061, 0.074, and 0.120, respectively. Patients intensified with insulin and TZD had the most incidences of all-cause mortality [(Incidence rate (IR) = 2.993/100 person-years) and CVD (IR = 3.579/100 person-years), respectively. Insulin users were associated with the higher risks in all cause-mortality (HR = 2.24, P < 0.01; 2.07, P < 0.01) and SH (HR = 1.17, P < 0.01; HR = 1.53, P < 0.01) than TZD and DPP4 inhibitor users. When compared to DPP4 inhibitors, TZDs were associated with higher risk of SH (HR = 1.31, P < 0.01) and CV diseases (HR = 1.28, P < 0.01). Conclusions: This study sheds new light on the understanding of insulin, DPP4 inhibitor and TZD in terms of their associated risks of all-cause mortality, SH and CV disease events. These findings are one of many factors that should be taken into account when making clinical decisions in deciding the choices of third-line glucose-lowering medications. DPP4 as the third-line medication has the lowest risk of SH and CV adverse effects, and posed no increased risks for mortality.
DescriptionE-Poster Session: Complications and Comorbidities
Persistent Identifierhttp://hdl.handle.net/10722/272049
ISSN
2023 Impact Factor: 3.3
2023 SCImago Journal Rankings: 1.134
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, CKH-
dc.contributor.authorShi, YM-
dc.contributor.authorHo, CW-
dc.contributor.authorTse, TYE-
dc.contributor.authorLam, CLK-
dc.date.accessioned2019-07-20T10:34:39Z-
dc.date.available2019-07-20T10:34:39Z-
dc.date.issued2019-
dc.identifier.citation29th European Meeting on Hypertension and Cardiovascular Protection (ESH 2019), Milan, Italy, 21-24 June 2019. ESH 2019 Abstract Book in Journal of Hypertension, 2019, v. 37 n. Suppl. 1, p. e309-e310-
dc.identifier.issn0263-6352-
dc.identifier.urihttp://hdl.handle.net/10722/272049-
dc.descriptionE-Poster Session: Complications and Comorbidities-
dc.description.abstractObjective: To examine risks of all-cause mortality, cardiovascular (CV) diseases and severe hypoglycaemia (SH) in patients with diabetes who were intensified with dipeptidylpeptidase-4 (DPP4) inhibitors, insulin, or Thiazolidinediones (TZDs) following metformin-sulfonylurea dual therapy failure. Design and method: We assembled a retrospective cohort data of 17,494 patients who were free of CV diseases, failed to metformin-sulfonylurea dual therapy, and were intensified with DPP4 inhibitors (n = 8,281), insulin (n = 6,559), or TZD (n = 2,654) from January 1, 2006 to January 31, 2018. Propensity-score (PS) weighting was used to balance out baseline covariates across the three groups. Hazard ratios (HRs) for all-cause mortality, CV diseases and SH were assessed using Cox proportional hazard models. Results: Over a mean follow-up period of 34 months with 50,188 person-years, cumulative incidences of all-cause mortality, CVD and SH were 0.061, 0.074, and 0.120, respectively. Patients intensified with insulin and TZD had the most incidences of all-cause mortality [(Incidence rate (IR) = 2.993/100 person-years) and CVD (IR = 3.579/100 person-years), respectively. Insulin users were associated with the higher risks in all cause-mortality (HR = 2.24, P < 0.01; 2.07, P < 0.01) and SH (HR = 1.17, P < 0.01; HR = 1.53, P < 0.01) than TZD and DPP4 inhibitor users. When compared to DPP4 inhibitors, TZDs were associated with higher risk of SH (HR = 1.31, P < 0.01) and CV diseases (HR = 1.28, P < 0.01). Conclusions: This study sheds new light on the understanding of insulin, DPP4 inhibitor and TZD in terms of their associated risks of all-cause mortality, SH and CV disease events. These findings are one of many factors that should be taken into account when making clinical decisions in deciding the choices of third-line glucose-lowering medications. DPP4 as the third-line medication has the lowest risk of SH and CV adverse effects, and posed no increased risks for mortality.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins, Ltd. The Journal's web site is located at http://www.jhypertension.com/-
dc.relation.ispartofJournal of Hypertension-
dc.relation.ispartof29th European Meeting on Hypertension and Cardiovascular Protection (ESH 2019)-
dc.titleTriple Therapy with Dpp4 Inhibitor, Insulin, or Thiazolidinediones and Risks of Cardiovascular Diseases and All-Cause Mortality in Patients with Failed Metformin-SU Therapy-
dc.typeConference_Paper-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailShi, YM: yrshi@HKUCC-COM.hku.hk-
dc.identifier.emailHo, CW: hochuwa@hku.hk-
dc.identifier.emailTse, TYE: emilyht@hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityTse, TYE=rp02382-
dc.identifier.authorityLam, CLK=rp00350-
dc.identifier.doi10.1097/01.hjh.0000573884.78506.aa-
dc.identifier.hkuros298762-
dc.identifier.volume37-
dc.identifier.issueSuppl. 1-
dc.identifier.spagee309-
dc.identifier.epagee310-
dc.identifier.isiWOS:000481429700909-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0263-6352-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats