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KMID : 0368120180480050395
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Korean Circulation Journal
2018 Volume.48 No. 5 p.395 ~ p.405
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Comparative Cardiovascular Risks of Dipeptidyl Peptidase-4 Inhibitors: Analyses of Real-world Data in Korea
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Ha Kyoung-Hwa
Kim Bong-Seong
Shin Hae-Sol
Lee Jin-Hee
Choi Han-Sol
Kim Hyeon-Chang
Kim Dae-Jung
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Abstract
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Background and Objectives: To compare cardiovascular disease (CVD) risk associated with 5 different dipeptidyl peptidase-4 inhibitors (DPP-4is) in people with type 2 diabetes.
Methods: We identified 534,327 people who were newly prescribed sitagliptin (n=167,157), vildagliptin (n=67,412), saxagliptin (n=29,479), linagliptin (n=220,672), or gemigliptin (n=49,607) between January 2013 and June 2015 using the claims database of the Korean National Health Insurance System. A Cox proportional hazards model was used to estimate hazard ratios (HRs) for major CVD events (myocardial infarction, stroke, or death) among users of different DPP-4is. The model was adjusted for sex, age, duration of DPP-4i use, use of other glucose-lowering drugs, use of antiplatelet agents, hypertension, dyslipidemia, atrial fibrillation, chronic kidney disease, microvascular complications of diabetes, Charlson comorbidity index, and the calendar index year as potential confounders.
Results: Compared to sitagliptin users, the fully adjusted HRs for CVD events were 0.97 (95% confidence interval [CI], 0.94?1.01; p=0.163) for vildagliptin, 0.76 (95% CI, 0.71?0.81; p<0.001) for saxagliptin, 0.95 (95% CI, 0.92?0.98; p<0.001) for linagliptin, and 0.84 (95% CI, 0.80?0.88; p<0.001) for gemigliptin.
Conclusions: Compared to sitagliptin therapy, saxagliptin, linagliptin, and gemigliptin therapies were all associated with a lower risk of cardiovascular events.
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KEYWORD
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Type 2 diabetes mellitus, Cardiovascular diseases, Dipeptidyl-peptidase IV inhibitors
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