Acarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studies

Aims: To assess if treatment with the alpha-glucosidase inhibitor acarbose can reduce cardiovascular events in type 2 diabetic patients. Methods and results: This meta-anatysis included seven randomized, double-blind, placebo-controlled acarbose studies with a minimum treatment duration of 52 weeks. Type 2 diabetic patients valid for safety were randomized to either acarbose (n=1 248) or placebo (n=932). The primary outcome measure was the time to develop a cardiovascular event. Primary analysis was conducted using Cox regression analysis. The effect of acarbose on metabolic parameters was also investigated. Acarbose therapy showed favourable trends towards risk reduction for all selected cardiovascular event categories. The treatment significantly reduced the risk for 'myocardial infarction' (hazards ratio=0. 36 [95% Cl 0.16-0.80], P=0.0120) and 'any cardiovascular event' (0.65 [95% Cl 0.48-0.88], P=0.0061). Glycaemic control, triglyceride levels, body weight and systolic blood pressure also improved significantly during acarbose treatment. Conclusion: Intervention with acarbose can prevent myocardial infarction and cardiovascular disease in type 2 diabetic patients white most of them are already on intensive concomitant cardiovascular medication. (C) 2003 Published by Elsevier Ltd on behalf of The European Society of Cardiology.