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논문 기본 정보

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학술저널
저자정보
정인하 (강북삼성병원) 권혜미 (성균관대학교) 박세은 (성균관대학교) 한경도 (숭실대학교) 박영규 (가톨릭대학교) 이은정 (성균관대학교) 이원영 (성균관대학교)
저널정보
대한내분비학회 Endocrinology and Metabolism Endocrinology and Metabolism Vol.36 No.5
발행연도
2021.10
수록면
977 - 987 (11page)
DOI
https://doi.org/10.3803/EnM.2021.1046

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Background: Patients with diabetes have a higher risk of requiring repeated percutaneous coronary intervention (PCI) than non-diabetic patients. We aimed to evaluate and compare the effects of anti-diabetic drugs on the secondary prevention of myocardial infarction among type 2 diabetes mellitus patients. Methods: We analyzed the general health check-up dataset and claims data of the Korean National Health Insurance Service of199,714 participants (age ≥30 years) who underwent PCIs between 2010 and 2013. Those who underwent additional PCI within 1year of their first PCI (n=3,325) and those who died within 1 year (n=1,312) were excluded. Patients were classified according totheir prescription records for glucose-lowering agents. The primary endpoint was the incidence rate of coronary revascularization. Results: A total of 35,348 patients were included in the study. Metformin significantly decreased the risk of requiring repeat PCI inall patients (adjusted hazard ratio [aHR], 0.77). In obese patients with body mass index (BMI) ≥25 kg/m2, patients treated with thiazolidinedione (TZD) exhibited a decreased risk of requiring repeat revascularization than those who were not treated with TZD(aHR, 0.77; 95% confidence interval, 0.63 to 0.95). Patients treated with metformin showed a decreased risk of requiring revascularization regardless of their BMI. Insulin, meglitinide, and alpha-glucosidase inhibitor were associated with increased risk of repeatedPCI. Conclusion: The risk of requiring repeat revascularization was lower in diabetic patients treated with metformin and in obese patients treated with TZD. These results suggest that physicians should choose appropriate glucose-lowering agents for the secondaryprevention of coronary artery disease.

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