| Summary: | 碩士 === 高雄醫學大學 === 藥學系碩士在職專班 === 104 === Background:
Saxagliptin is an oral hypoglycemic agent that can control blood sugar by inhibiting the metabolism of incretin. Several research studies recently showed that saxagliptin may increase the risk of cardiovascular events recetently. The aims of our study were to evaluate the risk of cardio-cerebral vascular events in patients who received saxagliptin and explore the precipitating risk factors of cardio-cerebral vascular events.
Methods:
There were two parts in our study. First, a systemic review and meta-analysis of randomized controlled studies of comparing saxagliptin to placebo with cardio-cerebral vascular events was conducted. Databases were searched for relevant published articles. Second, a retrospective cohort study was performed based on medical records of a medical center in southern Taiwan. Data such as patient’s basic information, medication records, lab data and diagnostic records were extracted and used to explore the risk factors of cardio-cerebral vascular events.
Results:
Six randomized controlled studies were included in the meta-analysis. Compared to control, treatment with saxagliptin significantly increased the risk of heart failure (RR=1.25, 95%CI：1.05-1.48；p value=0.01). Saxagliptin did not increase the risk of myocardial infarction and angina. The result of subgroup stratified by cardiovascular history showed that treatment with saxagliptin increased risk of heart failure (RR=1.26, 95%CI：1.06-1.49；p value=0.009) in the subgroup with CV history. Retrospective cohort study explored the significant risk factors of developing cardio-cerebral vascular events in patients who used saxagliptin were heart failure history (OR=3.395, 95%CI：1.118-10.305；p value=0.031) and atherosclerosis disease history OR=2.936, 95%CI： 1.017-8.481; p value=0.047).
Conclusions:
Our study showed that the usage of saxagliptin may increase the risk of heart failure in type 2 diabetes patients with history of cardiovascular disease. We found that the heart failure history and atherosclerosis disease history were important risk factors for developing cardio-cerebral vascular events.
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