VANCOUVER, B.C. — Acarbose markedly reduces the risk of cardiovascular events in patients with type 2 diabetes, according to a metaanalysis of seven randomized trials, Dieter Petzinna, M.D., said at a meeting sponsored by the International Academy of Cardiology.
The trials, each double-blind, placebo-controlled, and of at least 1 year's duration, included 2,180 patients with type 2 diabetes mellitus. Roughly 60% of participants were on background intensive cardiovascular risk reduction therapy, including statins, ACE inhibitors, and antiplatelet agents.
The primary end point in the metaanalysis was the occurrence of any newly diagnosed cardiovascular event. The rate was 6.1% in the acarbose patients and 9.4% in the placebo patients, for a highly significant 35% relative risk reduction favoring acarbose, said Dr. Petzinna of Bayer HealthCare, Wuppertal, Germany.
The reduction in overall cardiovascular events was driven largely by a 64% decrease in the relative risk of MI. The incidence was 2.0% in the placebo arm and 0.7% in patients assigned to acarbose.
There was also a consistent but statistically nonsignificant trend for lower rates of new-onset heart failure, angina, stroke, peripheral vascular disease, revascularization procedures, and cardiovascular death in the acarbose group.
Treatment with acarbose significantly lowered triglyceride levels, body weight, and systolic blood pressure. It also significantly improved glycemic control. These metabolic benefits, as well as the reduction in cardiovascular events, are attributable to the drug's ability to curb postprandial blood glucose excursions, which are known to trigger a cascade of atherogenic events, he said.