Acarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studies
Abstract
AIMS: To assess if treatment with the alpha-glucosidase inhibitor acarbose can reduce cardiovascular events in type 2 diabetic patients. METHODS AND RESULTS: This meta-analysis included seven randomized, double-blind, placebo-controlled acarbose studies with a minimum treatment duration of 52 weeks. Type 2 diabetic patients valid for safety were randomized to either acarbose (n=1248) or placebo (n=932). The primary outcome measure was the time to develop a cardiovascular event. Primary analysis was conducted using Cox regression analysis. The effect of acarbose on metabolic parameters was also investigated. Acarbose therapy showed favourable trends towards risk reduction for all selected cardiovascular event categories. The treatment significantly reduced the risk for "myocardial infarction" (hazards ratio=0.36 [95% Cl 0.16-0.80], P=0.0120) and "any cardiovascular event" (0.65 [95% Cl 0.48-0.88], P=0.0061). Glycaemic control, triglyceride levels, body weight and systolic blood pressure also improved significantly during acarbose treatment. CONCLUSION: Intervention with acarbose can prevent myocardial infarction and cardiovascular disease in type 2 diabetic patients while most of them are already on intensive concomitant cardiovascular medication.
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A causal relationship has been demonstrated between postprandial hyperglycemia and increased risk of cardiovascular diseases.
“and increased the risk of cardiovascular diseases occurring [12, 13].”
Cites
Haffner, S. M., Lehto, S., Rönnemaa, T., Pyörälä, K., & Laakso, M. (1998) · New England Journal of Medicine · doi:10.1056/nejm199807233390404 · Cited by 7,000 · see citing works
Global Burden of Diabetes, 1995–2025: Prevalence, numerical estimates, and projections
King, H. O. M., Aubert, R. E., & Herman, W. H. (1998) · Diabetes Care · doi:10.2337/diacare.21.9.1414 · Cited by 6,267 · see citing works
Stamler, J., Vaccaro, O., Neaton, J. D., Wentworth, D., & The Multiple Risk Factor Intervention Trial Research Group (1993) · Diabetes Care · doi:10.2337/diacare.16.2.434 · Cited by 4,063 · see citing works
Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial
Chiasson, J.-L., Josse, R. G., Gomis, R., Hanefeld, M., Karasik, A., & Laakso, M. (2002) · The Lancet · doi:10.1016/s0140-6736(02)08905-5 · Cited by 2,543 · see citing works
Self-citationTurner, R. C., Millns, H., Neil, H. A. W., Stratton, I. M., Manley, S. E., Matthews, D. R., & Holman, R. R. (1998) · BMJ · doi:10.1136/bmj.316.7134.823 · Cited by 2,014 · see citing works
Coutinho, M., Gerstein, H. C., Wang, Y., & Yusuf, S. (1999) · Diabetes Care · doi:10.2337/diacare.22.2.233 · Cited by 1,685 · see citing works
Chiasson, J.-L., Josse, R. G., Gomis, R., Hanefeld, M., Karasik, A., Laakso, M., & for The STOP-NIDDM Trial Research Group (2003) · JAMA · doi:10.1001/jama.290.4.486 · Cited by 1,624 · see citing works
Self-citationPyörälä, K., Pedersen, T. R., Kjekshus, J., Faergeman, O., Olsson, A. G., Thorgeirsson, G., & The Scandinavian Simvastatin Survival Study (4S) Group (1997) · Diabetes Care · doi:10.2337/diacare.20.4.614 · Cited by 1,623 · see citing works
Glucose Tolerance and Cardiovascular Mortality: Comparison of Fasting and 2-Hour Diagnostic Criteria
(2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.3.397 · Cited by 1,371 · see citing works
Goldberg, R. B., Mellies, M. J., Sacks, F. M., Moyé, L. A., Howard, B. V., Howard, W. J., Davis, B. R., Cole, T. G., Pfeffer, M. A., & Braunwald, E. (1998) · Circulation · doi:10.1161/01.cir.98.23.2513 · Cited by 986 · see citing works
Diabetes and atherosclerosis: An epidemiologic view
Pyörälà, K., Laakso, M., & Uusitupa, M. I. J. (1987) · Diabetes/Metabolism Reviews · doi:10.1002/dmr.5610030206 · Cited by 912 · see citing works
Hanefeld, M., Fischer, S., Julius, U., Schulze, J., Schwanebeck, U., Schmechel, H., Ziegelasch, H. J., & Lindner, J. (1996) · Diabetologia · doi:10.1007/s001250050617 · Cited by 873 · see citing works
Self-citationMalmberg, K., Yusuf, S., Gerstein, H. C., Brown, J., Zhao, F., Hunt, D. U., Piegas, L. S., Calvin, J. E., Keltai, M., Budaj, A., et al. (2000) · Circulation · doi:10.1161/01.cir.102.9.1014 · Cited by 746 · see citing works
Impact of Diabetes on Mortality After the First Myocardial Infarction
Miettinen, H., Lehto, S., Salomaa, V., Mähönen, M., Niemelä, M., Haffner, S. M., Pyörälä, K., Tuomilehto, J., & The FINMONICA Myocardial Infarction Register Study Group (1998) · Diabetes Care · doi:10.2337/diacare.21.1.69 · Cited by 665 · see citing works
Fontbonne, A., Eschw�ge, E., Cambien, F., Richard, J. L., Ducimeti�re, P., Thibult, N., Warnet, J., Claude, J., & Rosselin, G. (1989) · Diabetologia · doi:10.1007/bf00265546 · Cited by 616 · see citing works
Temelkova-Kurktschiev, T. S., Koehler, C., Henkel, E., Leonhardt, W., Fuecker, K., & Markolf Hanefeld, E. (2000) · Diabetes Care · doi:10.2337/diacare.23.12.1830 · Cited by 543 · see citing works
Affner, S. T. M. H., Ehto, S. E. L., Önnemaa, T. A. R., Yörälä, K. A. P., & Aakso, M. A. L. (1998) · Cited by 480 · see citing works
Chiasson, J., Josse, R. G., Hunt, J. A., Palmason, C., Rodger, N. W., Ross, S. A., Ryan, E. A., Tan, M. H., & Wolever*, T. M. S. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-121-12-199412150-00004 · Cited by 433 · see citing works
Barrett-Connor, E., & Ferrara, A. (1998) · Diabetes Care · doi:10.2337/diacare.21.8.1236 · Cited by 369 · see citing works
Hoffmann, J., & Spengler, M. (1997) · The American Journal of Medicine · doi:10.1016/s0002-9343(97)00252-0 · Cited by 147 · see citing works
Laube, H. (2002) · Clinical Drug Investigation · doi:10.2165/00044011-200222030-00001 · Cited by 125 · see citing works
Post-meal coagulation activation in diabetes mellitus: the effect of acarbose
Ceriello, A., Taboga, C., Tonutti, L., Giacomello, R., Stel, L., Motz, E., & Pirisi, M. (1996) · Diabetologia · doi:10.1007/bf00400679 · Cited by 113 · see citing works
A Prospective Study of Obesity and Risk of Coronary Heart Disease Among Diabetic Women
Cho, E., Manson, J. E., Stampfer, M. J., Solomon, C. G., Colditz, G. A., Speizer, F. E., Willett, W. C., & Hu, F. B. (2002) · Diabetes Care · doi:10.2337/diacare.25.7.1142 · Cited by 110 · see citing works
Acarbose in the treatment of elderly patients with type 2 diabetes
Josse, R. G., Chiasson, J.-L., Ryan, E. A., Lau, D. C. W., Ross, S. A., Yale, J.-F., Leiter, L. A., Maheux, P., Tessier, D., Wolever, T. M. S., et al. (2003) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(02)00176-6 · Cited by 110 · see citing works
Mertes, G. (2001) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(01)00221-2 · Cited by 101 · see citing works
Effect of the postprandial state on nontraditional risk factors
Lebovitz, H. E. (2001) · The American Journal of Cardiology · doi:10.1016/s0002-9149(01)01833-1 · Cited by 68 · see citing works
Birth weight and the Metabolic Syndrome: thrifty phenotype or thrifty genotype?
Stern, M. P., Bartley, M., Duggirala, R., & Bradshaw, B. (2000) · Diabetes/Metabolism Research and Reviews · doi:10.1002/(sici)1520-7560(200003/04)16:2 · Cited by 65 · see citing works
Effect of acarbose on postprandial lipid metabolism in type 2 diabetes mellitus
Kado, S., Murakami, T., Aoki, A., Nagase, T., Katsura, Y., Noritake, M., Matsuoka, T., & Nagata, N. (1998) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(98)00062-x · Cited by 59 · see citing works
Pharmacology of Glucosidase Inhibitors
Puls, W. (1996) · Handbook of experimental pharmacology · doi:10.1007/978-3-662-09127-2_17 · Cited by 49 · see citing works
Hasche, H., Mertes, G., Bruns, C., et al. (1999) · PubMed · Cited by 40 · see citing works
Rosenthal, J. H., & Mauersberger, H. (2002) · Clinical Drug Investigation · doi:10.2165/00044011-200222100-00006 · Cited by 31 · see citing works
Post-meal coagulation activation in diabetes mellitus: the effect of acarbose
Ceriello, A., Taboga, C., Tonutti, L., et al. (1996) · Diabetologia · doi:10.1007/s001250050467 · Cited by 14 · see citing works
Acarbose Maintains Glycaemic Control in Diet Treated Type 2 Diabetes
Holman, R. R., Robertson-Mackay, F., Gibbons, F. K., et al. (1999) · Clinical Science · doi:10.1042/cs096007p · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Global guideline for type 2 diabetes
(2014) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2012.10.001 · Cited by 1,064 · see citing works
Postprandial Hyperglycemia and Diabetes Complications
Ceriello, A. (2005) · Diabetes · doi:10.2337/diabetes.54.1.1 · Cited by 945 · see citing works
Augustin, L. S. A., Kendall, C. W. C., Jenkins, D. J. A., Willett, W. C., Astrup, A., Barclay, A. W., Björck, I., Brand-Miller, J. C., Brighenti, F., Buyken, A. E., et al. (2015) · Nutrition, Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2015.05.005 · Cited by 707 · see citing works
α-Glucosidase Inhibitors for Patients With Type 2 Diabetes
van de Laar, F. A., Lucassen, P. L., Akkermans, R. P., van de Lisdonk, E. H., Rutten, G. E., & van Weel, C. (2005) · Diabetes Care · doi:10.2337/diacare.28.1.154 · Cited by 690 · see citing works
Garber, A. J., Handelsman, Y., Grunberger, G., Einhorn, D., Abrahamson, M. J., Barzilay, J. I., Blonde, L., Bush, M. A., DeFronzo, R. A., Garber, J. R., et al. (2020) · Endocrine Practice · doi:10.4158/cs-2019-0472 · Cited by 598 · see citing works
Cavalot, F., Petrelli, A., Traversa, M., Bonomo, K., Fiora, E., Conti, M., Anfossi, G., Costa, G., & Trovati, M. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-1005 · Cited by 569 · see citing works
O’Keefe, J. H., & Bell, D. S. H. (2007) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2007.03.107 · Cited by 538 · see citing works
Garber, A. J., Abrahamson, M. J., Barzilay, J. I., Blonde, L., Bloomgarden, Z. T., Bush, M. A., Dagogo-Jack, S., DeFronzo, R. A., Einhorn, D., Fonseca, V. A., et al. (2017) · Endocrine Practice · doi:10.4158/ep161682.cs · Cited by 435 · see citing works
Glycemic index and glycemic load: measurement issues and their effect on diet–disease relationships
Venn, B. J., & Green, T. J. (2007) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602942 · Cited by 395 · see citing works
Alpha-glucosidase inhibitors for type 2 diabetes mellitus
Van de Laar, F. A., Lucassen, P. L., Akkermans, R. P., Van de Lisdonk, E. H., Rutten, G. E., & Van Weel, C. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003639.pub2 · Cited by 335 · see citing works
Holman, R. R., Coleman, R. L., Chan, J. C. N., Chiasson, J.-L., Feng, H., Ge, J., Gerstein, H. C., Gray, R., Huo, Y., Lang, Z., et al. (2017) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(17)30309-1 · Cited by 323 · see citing works
Cavalot, F., Pagliarino, A., Valle, M., Di Martino, L., Bonomo, K., Massucco, P., Anfossi, G., & Trovati, M. (2011) · Diabetes Care · doi:10.2337/dc10-2414 · Cited by 322 · see citing works
Garber, A. J., Abrahamson, M. J., Barzilay, J. I., Blonde, L., Bloomgarden, Z. T., Bush, M. A., Dagogo-Jack, S., DeFronzo, R. A., Einhorn, D., Fonseca, V. A., et al. (2019) · Endocrine Practice · doi:10.4158/cs-2018-0535 · Cited by 297 · see citing works
Chiavaroli, L., Lee, D., Ahmed, A., Cheung, A., Khan, T. A., Blanco, S., Mejia, Mirrahimi, A., Jenkins, D. J. A., Livesey, G., et al. (2021) · BMJ · doi:10.1136/bmj.n1651 · Cited by 215 · see citing works
Sievenpiper, J. L. (2020) · Nutrition Reviews · doi:10.1093/nutrit/nuz082 · Cited by 144 · see citing works
Nakatani, Y., Maeda, M., Matsumura, M., Shimizu, R., Banba, N., Aso, Y., Yasu, T., & Harasawa, H. (2017) · Diabetes & Metabolism · doi:10.1016/j.diabet.2017.05.009 · Cited by 126 · see citing works
Beejmohun, V., Peytavy-Izard, M., Mignon, C., Muscente-Paque, D., Deplanque, X., Ripoll, C., & Chapal, N. (2014) · BMC Complementary and Alternative Medicine · doi:10.1186/1472-6882-14-351 · Cited by 97 · see citing works
Value of Self-Monitoring Blood Glucose Pattern Analysis in Improving Diabetes Outcomes
Parkin, C. G., & Davidson, J. A. (2009) · Journal of Diabetes Science and Technology · doi:10.1177/193229680900300314 · Cited by 96 · see citing works
Monnier, L., Colette, C., & Owens, D. R. (2009) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.962 · Cited by 89 · see citing works
Acarbose: oral antidiabetes drug with additional cardiovascular benefits
Hanefeld, M., & Schaper, F. (2008) · Expert Review of Cardiovascular Therapy · doi:10.1586/14779072.6.2.153 · Cited by 87 · see citing works
Monnier, L., Benichou, M., Charra-Ebrard, S., Boegner, C., & Colette, C. (2005) · Diabetes & Metabolism · doi:10.1016/s1262-3636(07)70174-x · Cited by 69 · see citing works
AMPK is associated with the beneficial effects of antidiabetic agents on cardiovascular diseases
Lu, Q., Li, X., Liu, J., Sun, X., Rousselle, T., Ren, D., Tong, N., & Li, J. (2019) · Bioscience Reports · doi:10.1042/bsr20181995 · Cited by 69 · see citing works
Cosson, E., Hamo-Tchatchouang, E., Dufaitre-Patouraux, L., Attali, J.-R., Pariès, J., & Schaepelynck-Bélicar, P. (2009) · Diabetes & Metabolism · doi:10.1016/j.diabet.2009.02.006 · Cited by 57 · see citing works
Sakaguchi, K., Hirota, Y., Hashimoto, N., Ogawa, W., Hamaguchi, T., Matsuo, T., Miyagawa, J.-I., Namba, M., Sato, T., Okada, S., et al. (2013) · Journal of Diabetes Science and Technology · doi:10.1177/193229681300700313 · Cited by 50 · see citing works
Shimabukuro, M., Tanaka, A., Sata, M., Dai, K., Shibata, Y., Inoue, Y., Ikenaga, H., Kishimoto, S., Ogasawara, K., Takashima, A., et al. (2017) · Cardiovascular Diabetology · doi:10.1186/s12933-017-0571-1 · Cited by 38 · see citing works
Fukaya, N., Mochizuki, K., Tanaka, Y., Kumazawa, T., Jiuxin, Z., Fuchigami, M., & Goda, T. (2009) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2009.09.048 · Cited by 30 · see citing works
- Authors
- Hanefeld, M.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-01
- Volume
- 25
- Issue
- 1
- Pages
- 10-16
- ISSN
- 0195-668X (ISSN-L)
- OpenAlex
- W2029749250
- Cited by
- 641
- References
- 35
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 11 · 2022: 16 · 2021: 16 · 2020: 22 · 2019: 33 · 2018: 28 · 2017: 28 · 2016: 34 · 2015: 32 · 2014: 40 · 2013: 37 · 2012: 38
- FWCI
- 5.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- acarbose, alpha-glucosidase inhibitors, type 2 diabetes, myocardial infarction, cardiovascular events, cardiovascular risk reduction, glycemic control, triglycerides, blood pressure, body weight
- MeSH terms
- Diabetes Mellitus, Type 2, Diabetic Angiopathies, Enzyme Inhibitors, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Myocardial Infarction, Multicenter Studies as Topic, Proportional Hazards Models, Survival Analysis, Randomized Controlled Trials as Topic, Acarbose
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