title: Acarbose treatment and the risk of cardiovascular disease in type 2 diabetic patients: a nationwide seven-year follow-up study.
abstract: OBJECTIVE
  To investigate the potential benefits of acarbose treatment on cardiovascular disease (CVD) in patients with type 2 diabetes by using nationwide insurance claim dataset.
  
  
  METHODS
  Among 644,792 newly diagnosed type 2 diabetic patients without preexisting CVD in a nationwide cohort study, 109,139 (16.9%) who had received acarbose treatment were analyzed for CVD risk. Those with CVD followed by acarbose therapy were also subjected to analysis.
  
  
  RESULTS
  During 7 years of follow-up, 5,081 patients (4.7%) developed CVD. The crude hazard ratio (HR) and adjusted HR were 0.66 and 0.99, respectively. The adjusted HR of CVD was 1.19, 0.70, and 0.38 when the duration of acarbose use was <12 months, 12-24 months, and >24 months, respectively. Adjusted HR was 1.14, 0.64, and 0.41 with acarbose cumulative doses <54,750 mg, 54,751 to 109,500 mg, and >109,500 mg, respectively.
  
  
  CONCLUSIONS
  In patients with type 2 diabetes without preexisting CVD, treatment with acarbose showed a transient increase in incidence of CVD in the initial 12 months followed by significant reductions of CVD in prolonged acarbose users. After the first CVD events, continuous use of acarbose revealed neutral effect within the first 12 months. The underlying mechanisms require further investigations.
authors.affiliation: Department of Endocrinology and Metabolism, Tungs' Taichung MetroHarbor Hospital, Taichung 435, Taiwan ; Department of Biomedical Informatics, Asia University, Taichung 413, Taiwan ; Department of Gerontechnology and Service Management, Nan Kai University of Technology, Nantou 542, Taiwan.
authors.forename: Jui-Ming
authors.initials: JM
authors.lastname: Chen
authors.affiliation: Department of Information Management, Hsing Wu University, New Taipei City 244, Taiwan.
authors.forename: Cheng-Wei
authors.initials: CW
authors.lastname: Chang
authors.affiliation: Department of Biomedical Informatics, Asia University, Taichung 413, Taiwan.
authors.forename: Ying-Chieh
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Biomedical Informatics, Asia University, Taichung 413, Taiwan ; Department of Computer Science and Information Engineering, National Central University, Chungli 320, Taiwan.
authors.forename: Jorng-Tzong
authors.initials: JT
authors.lastname: Horng
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Section 3, Taichung-Harbor Road, Taichung 407, Taiwan ; School of Medicine, National Defense Medical Center, Taipei 114, Taiwan ; School of Medicine, National Yang-Ming University, Taipei 112, Taiwan ; Institute of Medical Technology, National Chung-Hsing University, Taichung 402, Taiwan.
authors.forename: Wayne H-H
authors.initials: WH
authors.lastname: Sheu
mesh_terms: D020909:Acarbose / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D065089:Glycoside Hydrolase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D065840:Protective Factors; D012008:Recurrence; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D020909:Acarbose