title: Sitagliptin After Ischemic Stroke in Type 2 Diabetic Patients: A Nationwide Cohort Study.
abstract: The cerebrovascular safety and efficacy of sitagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with type 2 diabetes mellitus (T2DM) with ischemic stroke remains uncertain. The aim of this study was to assess the efficacy and safety of sitagliptin in patients with T2DM with recent ischemic stroke. We analyzed data from the Taiwan National Health Insurance Research Database between March 1, 2009, and December 31, 2011. Ischemic stroke patients were identified from individuals with T2DM. Patients who received sitagliptin were compared with those who did not to evaluate the cardiovascular safety and efficacy of sitagliptin. The primary outcome was a composite of ischemic stroke, myocardial infarction, or cardiovascular death. A total of 5145 type 2 diabetic patients with ischemic stroke met our inclusion criteria and were followed for up to 2.83 years (mean, 1.17 years). Overall, 1715 patients (33.3%) received sitagliptin and 3430 patients (66.7%) did not. The primary composite outcome occurred in 190 patients in the sitagliptin group (11.1%) and in 370 patients in the comparison group (10.8%) (hazard ratio [HR] = 1.02; 95% confidence interval [CI], 0.85-1.21). Patients treated with sitagliptin had a similar risk of ischemic stroke, hemorrhagic stroke, and all-cause mortality with an HR of 0.95 (95% CI, 0.78-1.16, P = 0.612), 1.07 (95% CI, 0.55-2.11, P = 0.834), and 1.00 (95% CI, 0.82-1.22, P = 0.989), respectively, compared with patients not treated with sitagliptin. Treatment with sitagliptin in type 2 diabetic patients with recent ischemic stroke was not associated with increased or decreased risks of adverse cerebrovascular outcomes.
authors.affiliation: From the Division of Cardiology (DYC, MLT, CCC, MSW, CCW, ICH, KCH), Department of Internal Medicine; Department of Medical Education (SHW), Chang Gung Memorial Hospital, Chang Gung University College of Medicine; Division of Cardiology (CTM, WJC, THC), Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, and Chang Gung University College of Medicine, Taoyuan; Division of Cardiology (YSL), Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, and Chang Gung University College of Medicine, Taoyuan; and Department of Neurology (FCS), Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Dong-Yi
authors.initials: DY
authors.lastname: Chen
authors.forename: Szu-Heng
authors.initials: SH
authors.lastname: Wang
authors.forename: Chun-Tai
authors.initials: CT
authors.lastname: Mao
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Tsai
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Feng-Chieh
authors.initials: FC
authors.lastname: Su
authors.forename: Chung-Chuan
authors.initials: CC
authors.lastname: Chou
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Wang
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Hsieh
authors.forename: Kuo-Chun
authors.initials: KC
authors.lastname: Hung
authors.forename: Wen-Jin
authors.initials: WJ
authors.lastname: Cherng
authors.forename: Tien-Hsing
authors.initials: TH
authors.lastname: Chen
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011719:Pyrazines / Q000627:therapeutic use*; D000068900:Sitagliptin Phosphate; D020521:Stroke / Q000139:chemically induced / Q000517:prevention & control*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D011719:Pyrazines; D014230:Triazoles; D000068900:Sitagliptin Phosphate