Association of smoking and concomitant metformin use with cardiovascular events and mortality in people newly diagnosed with type 2 diabetes
File(s)
Accepted version
Author(s)
Paul, SK
Klein, K
Majeed, A
Khunti, K
Type
Journal Article
Abstract
Background: The cardiovascular and mortality risk in patients with incidenttype 2 diabetes (T2D) in relation to smoking status and concurrent use ofmetformin is not well known.Methods: A cohort study was performed in 82 205 incident T2D patientsfrom the UK Clinical Practice Research Datalink. In the present study, therisks of myocardial infarction (MI), stroke, and mortality in incident T2Dpatients were evaluated in relation to their smoking status with and withoutconcurrent use of metformin.Results: Over a median 5.4 years of follow-up, of patients without a history ofcardiovascular disease (CVD) before a diagnosis of diabetes (n = 63 166),current smokers with and without metformin had an 8% (hazard ratio [HR]1.08; 95% confidence interval [CI] 0.81, 1.45) and 32% (HR 1.32; 95% CI 1.07,1.65) increased risk of MI or stroke, respectively, compared with non-smokerswithout metformin treatment. The respective HRs (95% CI) for mortality inthese patients were 0.96 (0.83, 1.11) and 1.86 (1.68, 2.07). The HR for mortalityamong ex-smokers with and without concurrent metformin treatment was 0.92(95% CI 0.83, 1.11) and 1.19 (95% CI 1.10, 1.30), respectively. Similar beneficialmodifiable effects of metformin among ex- and current smokers were observedin patients with CVD before diagnosis of diabetes (n = 19 039).Conclusions: In T2D patients, concurrent treatment with metformin attenu-ates the observed higher cardiovascular and mortality risk in ex- and currentsmokers. In addition to smoking cessation support, treatment with metformin,particularly in ex- and current smokers, should be encouraged.
Date Issued
2015-07-14
Date Acceptance
2015-04-16
Citation
Journal of Diabetes, 2015, 8 (3), pp.354-362
ISSN
1753-0393
Publisher
Wiley
Start Page
354
End Page
362
Journal / Book Title
Journal of Diabetes
Volume
8
Issue
3
Copyright Statement
© 2015 John Wiley & Sons Ltd. "This is the peer reviewed version of the following article: Paul, S. K., Klein, K., Majeed, A., and Khunti, K. (2016) Association of smoking and concomitant metformin use with cardiovascular events and mortality in people newly diagnosed with type 2 diabetes. Journal of Diabetes, 8: 354–362, which has been published in final form at https://dx.doi.org/10.1111/1753-0407.12302. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving https://authorservices.wiley.com/author-resources/Journal-Authors/licensing-open-access/open-access/self-archiving.html
."
."
Subjects
Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
cardiovascular risk
metformin
mortality
smoking
type 2 diabetes
CORONARY-HEART-DISEASE
MYOCARDIAL-INFARCTION
RISK-FACTORS
METAANALYSIS
STROKE
WOMEN
COUNTRIES
CESSATION
MELLITUS
RECORDS
2型糖尿病
二甲双胍
吸烟
心血管风险
死亡率
Aged
Cardiovascular Diseases
Diabetes Mellitus, Type 2
Female
Follow-Up Studies
Humans
Hypoglycemic Agents
Male
Metformin
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Smoking
Survival Rate
Publication Status
Published