Copyright © 2004 by the European Society of Cardiology.
Clinical research
Acarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studies
a Centre for Clinical Studies, GWT, Technical University, Dresden, Germany
b Bayer AG, Wuppertal, Germany
c formerly Bayer AG, Wuppertal, Germany
* Correspondence to: Prof. Dr med. M. Hanefeld, Zentrum für Klinische Studien, Technische Universität Dresden, Fiedlerstr. 34, 01307 Dresden, Germany. Tel: +49 361 4400 580; fax: +49 361 4400 581
E-mail address: hanefeld{at}gwt-tud.de
Received 12 March 2003; revised 8 July 2003; accepted 31 July 2003
Abstract
Aims To assess if treatment with the 
-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.
Key Words: Acarbose • Cardiovascular events • Meta-analysis • Myocardial infarction • Risk reduction • Type 2 diabetes
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