| ABSTRACT Objective:To investigate whether acarbose treatment was associated with the potential benefits of coronary heart disease (CHD) in newly diagnosed patients with type 2 diabetes mellitus (T2DM) by using nationwide insurance claim dataset. Methods:A retrospective cohort study was conducted by using the Beijing Urban Employee Basic Medical Insurance database during 2012 2015. A total of 1 627 newly onset T2DM patients without CHD were identified in 2012 and followed until the earliest of outcome occurrence, the latest medical record or study termination. Time varying Cox proportional hazards regression was applied to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the association between acarbose treatment and incident of CHD, adjusted for patients' demographics, comorbidity, and co medications. Subgroup analysis were performed based on the cumulative duration and dosage of acarbose. Results:During 4 years of follow up, the primary outcome occurred in 379 patients (47.55%) who had received acarbose treatment, as compared with 539 patients (64.94%) who never took acarbose therapy, which suggested that acarbose users group had lower risks of developing CHD (P<0.05). By using those without exposure to acarbose as reference group, acarbose users revealed neutral adjusted HR 1.07 (95%CI: 0.93, 1.22) for developing CHD. However, further analysis indicated that the adjusted HR (95%CI) was 2.08 (1.77, 2.45), 0.79 (0.65, 0.97) and 0.29 (0.22, 0.39) when the duration of taking acarbose was <60 days, 60 180 days and >180 days, respectively. Moreover, the adjusted HR was 2.02 (1.73, 2.37), 0.72 (0.58, 0.89) and 0.23 (0.17, 0.32) with acarbose cumulative doses <14 000 mg, 14 000 48 000 mg and >48 000 mg, respectively. Conclusion:Newly diagnosed T2DM patients who used acarbose for a prolonged period or who reached certain amount of doses showed benefits on the development of coronary heart disease. |
