Open Access基于电子病历记录数据检测中国2型糖尿病患者服用吡格列酮及发生心血管事件的风险
Author(s) -
Miao Shumei,
Dong Xiao,
Zhang Xin,
Jing Shenqi,
Zhang Xiaoliang,
Xu Tingyu,
Wang Li,
Du Xianglin,
Xu Hua,
Liu Yun
Publication year - 2019
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12894
Subject(s) - pioglitazone , medicine , type 2 diabetes , confounding , stroke (engine) , diabetes mellitus , heart failure , cohort study , relative risk , confidence interval , myocardial infarction , endocrinology , mechanical engineering , engineering
Background Pioglitazone may have a protective effect against cardiovascular disease risk among type 2 diabetes (T2D) patients, but evidence from China is lacking. This study investigated the association using electronic health records (EHR) data from a Chinese cohort of T2D patients. Methods All T2D patients from the First Affiliated Hospital of Nanjing Medical University who were prescribed at least one oral antidiabetic drug and were aged ≥18 years between 1 July 2005 and 30 June 2017 were eligible for inclusion (n = 71 783). Pioglitazone use was determined in 6‐month study intervals, with outcome events of myocardial infarction (MI), ischemic stroke, and heart failure. Poisson regression was used to estimate adjusted rate ratios (RRs) with 95% confidence intervals (CIs). Results In multivariable analysis adjusted for potential confounders, pioglitazone use, compared with no use, was associated with a significant 39% decreased risk of MI (RR = 0.61; 95% CI = 0.42‐0.90; P = 0.012). Pioglitazone use was also associated with a non‐significant reduction in risk of heart failure or stroke. When MI, heart failure, and stroke were combined as a composite outcome, pioglitazone use was associated with a 30% decrease in risk (RR = 0.70; 95% CI = 0.56‐0.88; P = 0.002). Conclusions This study demonstrates that applying informatics tools to a large EHR database could be a good way to efficiently conduct clinical observational research. In addition, the findings validated the favorable effect of pioglitazone on the risk of MI among T2D patients in China, with the use of pioglitazone decreasing the risk of MI among those with T2D.