Publication details

Studie TECOS – efekt sitagliptinu na kardiovaskulární příhody u diabtes mellitus 2. typu

Title in English The TECOS study – the eff ect of sitagliptin on cardiovascular events in patients with type 2 diabetes mellitus
Authors

ŠPINAR Jindřich ŠPINAROVÁ Lenka VÍTOVEC Jiří

Year of publication 2015
Type Article in Periodical
Magazine / Source Kardiologická revue - Interní medicína
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords diabetes mellitus; sitagliptin; heart failure
Description Background: Sitagliptin, a dipeptidyl peptidase 4 inhibitor, is currently used in the treatment of patients with type 2 diabetes, however data are lacking on its long-term eff ect on cardiovascular events. Methods: In this randomised, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycaemic therapy was encouraged as required, aimed at reaching individually appropriate glycaemic targets in all patients. To determine whether sitagliptin was non-inferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and/or hospitalisation for unstable angina. Results: During an average follow-up of 3.0 years there was only a small decrease in glycated haemoglobin levels of 0.29 percentage points. Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%) and 851 patients in the placebo group (11.6%). Sitagliptin was non-inferior to placebo for the primary composite cardiovascular outcome (HR 0.98; p < 0.001). The rates of hospitalisation for heart failure did not diff er between the two groups (p = 0.98). There were no signifi cant between-group diff erences in the rates of acute pancreatitis (p = 0.07) or pancreatic cancer (p = 0.32). Conclusions: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to the usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalisation for heart failure, or other adverse events.

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