Sitagliptin pretreatment in diabetes patients presenting with acute coronary syndrome: Results from the Acute Coronary Syndrome Israeli Survey (ACSIS)

Eyal Leibovitz*, Shmuel Gottlieb, Ilan Goldenberg, Natalie Gevrielov-Yusim, Shlomi Matetzky, Dov Gavish

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Chronic treatment with currently available oral hypoglyemic medications may result in a differential effect on the clinical presentation of diabetic patients with acute coronary syndrome (ACS).Methods: We evaluated presentation characteristics and the risk for in-hospital complications and 30-day major adverse cardiovascular events (MACE) among 445 patients with diabetes mellitus enrolled in the Acute Coronary Syndrome Israeli Survey (ACSIS) 2010. Patients were categorized into 3 groups according to glucose lowering medications at time of admission for ACS: 1) DPP 4 inhibitors (as monotherapy or in combination; DPP4i), 2) Metformin (monotherapy or in combination, excluding DPP4i) and 3) other oral hypoglycemics.Results: Patients in the DPP4i group displayed similar baseline clinical characteristics to the other 2 groups, with the exception of a younger age and a lower frequency of prior coronary heart disease and chronic renal failure. Medical therapy with DPP4i was associated with a significantly lower in-hospital complication rate (post MI angina, re-infarction, pulmonary edema, infections, acute renal failure and better KILLIP class) (9.7%), lower rates of 30-day MACE (12.9%) and a shorter hospital stay (5.4 ± 3.8 days) as compared with patients treated with metformin (24.4%, 31.6% and 5.6 ± 5.0 days respectively) or other oral hypoglycemic drugs (45.5%, 48.5% and 7.5 ± 6.5 days respectively). Consistently, multivariate logistic regression modeling revealed that treatment with DPP4i was associated with a lower risk for in-hospital complications (OR = 0.129, p = 0.002) and 30-day MACE (OR = 0.157, p = 0.002) compared with other oral hypoglycaemic therapy.Conclusions: Our data suggests that chronic treatment with DPP4i may have cardioprotective effects in diabetes patients presenting with acute coronary syndrome.

Original languageEnglish
Article number53
JournalCardiovascular Diabetology
Volume12
Issue number1
DOIs
StatePublished - 28 Mar 2013

Keywords

  • Acute coronary syndrome
  • DPP4 inhibitors
  • Diabetes mellitus
  • Sitagliptin

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