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首页> 外文期刊>Diabetes care >Risk of cardiovascular disease events in patients with type 2 diabetes prescribed the glucagon-like peptide 1 (GLP-1) receptor agonist exenatide twice daily or other glucose-lowering therapies: a retrospective analysis of the LifeLink database.
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Risk of cardiovascular disease events in patients with type 2 diabetes prescribed the glucagon-like peptide 1 (GLP-1) receptor agonist exenatide twice daily or other glucose-lowering therapies: a retrospective analysis of the LifeLink database.

机译：2型糖尿病患者发生心血管疾病的风险规定，胰高血糖素样肽1（GLP-1）受体激动剂艾塞那肽每天两次或使用其他降糖疗法：LifeLink数据库的回顾性分析。

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OBJECTIVE: To test the hypothesis that exenatide twice daily reduces the relative incidence of cardiovascular disease (CVD) events among patients with type 2 diabetes compared with other glucose-lowering agent(s). RESEARCH DESIGN AND METHODS: A retrospective database analysis was performed of the LifeLink database of medical and pharmaceutical insurance claims for June 2005 through March 2009. Patients with no history in the preceding 9 months of myocardial infarction, ischemic stroke, or coronary revascularization procedure were assigned to the exenatide-initiated or non-exenatide-initiated cohorts based on the first new prescription filled and reassigned if exenatide was prescribed or discontinued. Incident CVD events (myocardial infarction, ischemic stroke, or coronary revascularization procedure) were identified by ICD-9-CM diagnosis codes. Patient outcomes were adjusted for differences in clinical and demographic characteristics and compared using propensity score-weighted discrete time survival analysis with time-varying exposure to exenatide. RESULTS: A total of 39,275 patients with type 2 diabetes were treated with exenatide twice daily, and 381,218 patients were treated with other glucose-lowering therapies. Patients who initiated exenatide were more likely to have prior ischemic heart disease, obesity, hyperlipidemia, hypertension, and/or other comorbidities at baseline. Exenatide-treated patients were less likely to have a CVD event than non-exenatide-treated patients (hazard ratio 0.81; 95% CI 0.68-0.95; P = 0.01) and lower rates of CVD-related hospitalization (0.88; 0.79-0.98; P = 0.02) and all-cause hospitalization (0.94; 0.91-0.97; P < 0.001). CONCLUSIONS: Exenatide twice-daily treatment was associated with a lower risk of CVD events and hospitalizations than treatment with other glucose-lowering therapies.
机译：目的：为了检验这样的假设：与其他降糖药相比，艾塞那肽每天两次可降低2型糖尿病患者心血管疾病（CVD）事件的相对发生率。研究设计和方法：对2005年6月至2009年3月的LifeLink医疗保险和医疗保险索赔数据库进行回顾性数据库分析。分配了在前9个月没有心肌梗塞，缺血性中风或冠脉血运重建手术史的患者依艾塞那肽开处方或中止的情况下，根据填写并重新分配的第一个新处方将艾塞那肽起始或未艾塞那肽起始的队列纳入研究对象。通过ICD-9-CM诊断代码确定了CVD事件（心肌梗塞，缺血性中风或冠状动脉血运重建过程）。调整患者结局以适应临床和人口统计学特征的差异，并使用倾向评分加权离散时间生存分析与艾塞那肽随时间变化的暴露进行比较。结果：总共39275例2型糖尿病患者每天接受艾塞那肽治疗两次，而381218例患者接受其他降糖治疗。起始艾塞那肽的患者在基线时更可能患有先前的缺血性心脏病，肥胖，高脂血症，高血压和/或其他合并症。与非艾塞那肽治疗的患者相比，艾塞那肽治疗的患者发生CVD事件的可能性较小（危险比0.81; 95％CI 0.68-0.95; P = 0.01），并且与CVD相关的住院率更低（0.88; 0.79-0.98; P = 0.02）和全因住院（0.94; 0.91-0.97; P <0.001）。结论：每天两次艾塞那肽治疗与发生其他降糖治疗相比，发生心血管疾病和住院的风险较低。

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