Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease

Jie Hong, Yifei Zhang, Shenghan Lai, Ankang Lv, Qing Su, Yan Dong, Zhiguang Zhou, Weili Tang, Jiajun Zhao, Lianqun Cui, Dajin Zou, Dawang Wang, Hong Li, Chao Liu, Guoting Wu, Jie Shen, Dalong Zhu, Weiqing Wang, Weifeng Shen, Guang Ning

Research output: Contribution to journalArticle

Abstract

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-termeffects of glipizide andmetformin on themajor cardiovascular events in type 2 diabetic patients who had a history of coronary artery disease (CAD). RESEARCH DESIGNANDMETHODS-This study is amulticenter, randomized, doubleblind, 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 (30mg daily) ormetformin (1.5 g daily) for 3 years. The primary end pointswere 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 themetformin 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.

Original languageEnglish (US)
Pages (from-to)1304-1311
Number of pages8
JournalDiabetes Care
Volume36
Issue number5
DOIs
StatePublished - May 2013

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Glipizide
Metformin
Type 2 Diabetes Mellitus
Coronary Artery Disease
Intention to Treat Analysis
Controlled Clinical Trials
Glycosylated Hemoglobin A
Hypoglycemic Agents
Cause of Death
Stroke
Myocardial Infarction
Placebos
Mortality
Therapeutics
Research
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease. / Hong, Jie; Zhang, Yifei; Lai, Shenghan; Lv, Ankang; Su, Qing; Dong, Yan; Zhou, Zhiguang; Tang, Weili; Zhao, Jiajun; Cui, Lianqun; Zou, Dajin; Wang, Dawang; Li, Hong; Liu, Chao; Wu, Guoting; Shen, Jie; Zhu, Dalong; Wang, Weiqing; Shen, Weifeng; Ning, Guang.

In: Diabetes Care, Vol. 36, No. 5, 05.2013, p. 1304-1311.

Research output: Contribution to journalArticle

Hong, J, Zhang, Y, Lai, S, Lv, A, Su, Q, Dong, Y, Zhou, Z, Tang, W, Zhao, J, Cui, L, Zou, D, Wang, D, Li, H, Liu, C, Wu, G, Shen, J, Zhu, D, Wang, W, Shen, W & Ning, G 2013, 'Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease', Diabetes Care, vol. 36, no. 5, pp. 1304-1311. https://doi.org/10.2337/dc12-0719
Hong, Jie ; Zhang, Yifei ; Lai, Shenghan ; Lv, Ankang ; Su, Qing ; Dong, Yan ; Zhou, Zhiguang ; Tang, Weili ; Zhao, Jiajun ; Cui, Lianqun ; Zou, Dajin ; Wang, Dawang ; Li, Hong ; Liu, Chao ; Wu, Guoting ; Shen, Jie ; Zhu, Dalong ; Wang, Weiqing ; Shen, Weifeng ; Ning, Guang. / Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease. In: Diabetes Care. 2013 ; Vol. 36, No. 5. pp. 1304-1311.
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T1 - Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease

AU - Hong, Jie

AU - Zhang, Yifei

AU - Lai, Shenghan

AU - Lv, Ankang

AU - Su, Qing

AU - Dong, Yan

AU - Zhou, Zhiguang

AU - Tang, Weili

AU - Zhao, Jiajun

AU - Cui, Lianqun

AU - Zou, Dajin

AU - Wang, Dawang

AU - Li, Hong

AU - Liu, Chao

AU - Wu, Guoting

AU - Shen, Jie

AU - Zhu, Dalong

AU - Wang, Weiqing

AU - Shen, Weifeng

AU - Ning, Guang

PY - 2013/5

Y1 - 2013/5

N2 - 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-termeffects of glipizide andmetformin on themajor cardiovascular events in type 2 diabetic patients who had a history of coronary artery disease (CAD). RESEARCH DESIGNANDMETHODS-This study is amulticenter, randomized, doubleblind, 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 (30mg daily) ormetformin (1.5 g daily) for 3 years. The primary end pointswere 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 themetformin 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.

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-termeffects of glipizide andmetformin on themajor cardiovascular events in type 2 diabetic patients who had a history of coronary artery disease (CAD). RESEARCH DESIGNANDMETHODS-This study is amulticenter, randomized, doubleblind, 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 (30mg daily) ormetformin (1.5 g daily) for 3 years. The primary end pointswere 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 themetformin 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.

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