Effect Of Acarbose Or Metformin Treatment On Cardiovascular Events In Patients With Impaired Glucose Tolerance Accompanied By Coronary Heart Disease

Objective To study the effect of acarbose or metformin treatment on cardiovascular events in patients with impaired glucose tolerance accompanied by coronary heart disease,and to compare the two drugs in intervention difference between curative aspects,so as to provide clinic physicans with gist and better treatment agent.Methods 180 Patients which department in The First Pepole Hospital of Jining during August 2008 to June 2010 with impaired glucose tolerance and coronary heart disease were randomized in three groups,metformin group,acarbose group, the control group, metformin group(60 Patients), received oral acarbose on basis of standard CHD therapy;acarbose group(60 Patients), received oral acarbose on basis of standard CHD therapy; the control group only received standard therapy without acarbose or merformin.All patients recept CAG.They all have coronary heart disease .Then,recept their basis events,include age,sex,BP,rate,FPG,st.Both groups were followed up for six moths.Cardiovascular events were evaluated at the end of follow up.Results 174 patients were fowolled for six moths. Metformin group include57 Patients, acarbose group include 59 Patients, the control group include 58 patients.Before intervention their basis events,include age,sex,BP,rate,FPG,st,there is no difference between them.After Drugs'intervention,fasting glucose,blood sugar after OGTT 2 hours and glycated hemoglobin are abviously decline in metformin group and acabose group.Acarbose group,after the intervention,FPG t=7.7394, P = 0.0000; OGTT 2 hours blood sugar t = 33.2938, P = 0.0000; Glycated hemoglobin t= 10.042, P = 0.0000. Metformin group after the intervention t = 8.2071,P = 0.0000; OGTT 2 hours blood sugar t = 13.661, P = 0.0000; Glycated hemoglobin t= 13.556, P = 0.0000. Compare Metformin group with acarbose group , fasting glucose t = 0.371,P = 0.7069; OGTT 2 hours blood sugar t = 24.57, P = 0.0000; Glycated hemoglobin t = 1.895, P = 0.0606.During follow-up period cardioascular events is22.41% (13/58) in the control group, metformin group is 8.77% (5/57), Comparied control group with metformin group,χ~2=4.0523,P=0.0441<0.05,acarbose group is 6.78% (4/59), Comparied control groupwith acarbose group,χ~2=5.7566,P=0.0164<0.05, Comparied Metformin group with acarbose groupχ~2=0.1608,P=0.6884>0.05.Conclusion Conventional for OGTT test, can improve IGT diagnosis in patients with coronary heart disease, acarbose and metformin all can reduce blood sugar after OGTT 2 hours and glycated hemoglobin,and in reduce blood sugar after OGTT 2hours acarbose is better than metformin.Both two medicine can decrease cardiovascular events in patients with impaired glucose tolerance accompaneid by coronary heart disease,not seen significance deference between them.