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Posted by on May 23, 2017 in Coronary artery disease | 0 comments

In a nutshell

This study aimed to investigate if using both an angiotensin converting enzyme (ACE) inhibitor and a dipeptidyl peptidase 4 inhibitor, alogliptin (Nesina) in type 2 diabetes mellitus patients with recent acute coronary syndrome led to increased risk of cardiovascular events.

This study concluded there was no increased risk of cardiovascular events between patients who used both agents and patients who used an ACE inhibitor alone. 

Some background

Type 2 diabetes is a condition associated with high blood sugar levels. In patients with type 2 diabetes, the body does not make enough insulin or the cells of the body become resistent to insulin. Insulin is the hormone needed to break down the glucose taken in from food. Dipeptidyl peptidase 4 inhibitors are drugs used in the treatment of type 2 diabetes to reduce blood sugar levels.  

Acute coronary syndrome (ACS) is the blockage of coronary arteries that deliver blood to the heart. ACS is commonly known as a heart attack. Angiotensin converting enzyme (ACE) inhibitors are used in the treatment of heart attacks.  

Patients who have type 2 diabetes and a history of a heart attack may need to take both these drugs. It was unknown if use of both inhibitors could lead to an increased risk of major heart related events. 

Methods & findings

3323 patients with type 2 diabetes undergoing ACE inhibitor treatment following a recent heart attack took part in this study. 51% of patients were treated with alogliptin (dipeptidyl peptidase 4 inhibitor) and 49% were treated with a placebo (drug that has no effect).

The risks of heart related events were measured in both groups. These included heart related death, non-fatal heart attack, stroke and hospitalized heart failure. Patients were followed for up to 18 months.

The rates of heart related death, non-fatal heart attack and non-fatal stroke were 11.4% for the alogliptin group and 11.8% for the placebo group. In comparison, in a group treated without ACE inhibitors, the rates were 11.2% in the alogliptin group and 11.9% in the placebo group. 

The rate of heart failure and heart related death was 6.8% for the alogliptin group and 7.2% for the placebo group. 

The bottom line

This study concluded that there was no increased risk of major heart events in patients treated with both dipeptidyl peptidase 4 inhibitors and ACE inhibitors when compared to patients treated with ACE inhibitors alone.

What’s next?

Consult your physician about treatment options available to you.

Published By :


Date :

Aug 01, 2016

Original Title :

Angiotensin-Converting Enzyme Inhibitor Use and Major Cardiovascular Outcomes in Type 2 Diabetes Mellitus Treated With the Dipeptidyl Peptidase 4 Inhibitor Alogliptin.

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