Postprandial Glucose Drug No Help for Established Heart Disease

Action Points

  • Note that this large randomized trial found that acarbose did not improve cardiovascular outcomes among patients with post-prandial hyperglycemia.
  • Be aware that acarbose works best when the diet is high in complex carbohydrates.

LISBON — For people with both coronary heart disease and impaired glucose tolerance, acarbose (Precose) had no effect on major cardiovascular events but did delay diabetes onset, the Chinese ACE trial showed.

With a primary composite endpoint of cardiovascular death, non-fatal MI or stroke, and hospital admission for unstable angina or heart failure, patients receiving the alpha-glucosidase inhibitor had about the same rates after a median of about 5 years as those assigned to placebo (14% versus 15%, HR 0.98, 95% CI 0.86-1.11), Rury Holman, FRCP, of the Diabetes Trials Unit at the University of Oxford in England, and colleagues found.

Nor did the agent, which tackles postprandial hyperglycemia by slowing complex carbohydrate digestion, improve composite risk of the primary endpoints plus death from any cause and fatal MI or stroke, and impaired renal function, the group reported here at the European Association for the Study of Diabetes and simultaneously online in Lancet Diabetes and Endocrinology.

“On the basis of the data from this trial and the NAVIGATOR study,” they wrote, “it seems that, despite the strong epidemiological data linking postprandial hyperglycemia to increased cardiovascular risk, directly targeting…

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