What does the Acarbose Cardiovascular Evaluation (ACE) trial tell us?

Holman, Rury R.

doi:10.1111/1753-0407.12770

Cited by 4 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The lipids that differed in abundance to control animals at 22 months of age were very similar in animals that began treatment at 4 or 16 months. The effects and implications of these lipidomic responses are still to be further evaluated, but might help to explain the improved protection from cardiovascular disease and events seen in some humans treated with ACA (37,38).…”

Section: Discussionmentioning

confidence: 99%

Early or Late-Life Treatment With Acarbose or Rapamycin Improves Physical Performance and Affects Cardiac Structure in Aging Mice

Herrera

Pifer

Louzon

et al. 2022

The Journals of Gerontology: Series A

View full text Add to dashboard Cite

Pharmacological treatments can extend lifespan in mice. For optimal translation in humans, treatments should improve health during aging, and demonstrate efficacy when started later in life. Acarbose (ACA) and Rapamycin (RAP) extend lifespan in mice when treatment is started early or later in life. Both drugs can also improve some indices of healthy aging, although there has been little systematic study of whether health benefits accrue differently depending on the age at which treatment is started. Here we compare the effects of early (4 month) versus late (16 month) onset ACA or RAP treatment on physical function and cardiac structure in genetically heterogeneous aged mice. ACA or RAP treatment improve rotarod acceleration and endurance capacity compared to controls, with effects that are largely similar in mice starting treatment from early or late in life. Compared to controls, cardiac hypertrophy is reduced by ACA or RAP in both sexes regardless of age treatment onset. ACA has a greater effect on the cardiac lipidome than RAP, and effects of early life treatment are recapitulated by late life treatment. These results indicate that late life treatment with these drugs provide at least some of the benefits of life long treatment, although some of the benefits occur only in males, which could lead to sex differences in health outcomes later in life.

show abstract

Section: Discussionmentioning

confidence: 99%

Early or Late-Life Treatment With Acarbose or Rapamycin Improves Physical Performance and Affects Cardiac Structure in Aging Mice

Herrera

Pifer

Louzon

et al. 2022

The Journals of Gerontology: Series A

View full text Add to dashboard Cite

show abstract

“…Recent studies have demonstrated cardio protection with sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists [18, 19] probably via non-glycaemic mechanisms. AGIs, however, might reduce CV risk indirectly in the longer term by delaying the onset of type 2 diabetes in people with IGT [20]. Such an effect was seen in the Chinese Da Qing study where a 6-year lifestyle intervention program which delayed the onset of type 2 diabetes was shown to be associated with an 11.9% reduction in CV death and a 28.1% reduction in all-cause mortality after 23 years follow-up [21].…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of the impact of alpha-glucosidase inhibitors on incident diabetes and cardiovascular outcomes

Coleman

Scott

Lang

et al. 2019

Cardiovasc Diabetol

Self Cite

View full text Add to dashboard Cite

Background Alpha-glucosidase inhibitors (AGIs) have been shown to reduce incident type 2 diabetes but their impact on cardiovascular (CV) disease remains controversial. We sought to identify the overall impact of AGIs with respect to incident type 2 diabetes in individuals with impaired glucose tolerance (IGT), and CV outcomes in those with IGT or type 2 diabetes. Methods We used PubMed and SCOPUS to identify randomized controlled trials reporting the incidence of type 2 diabetes and/or CV outcomes that had compared AGIs with placebo in populations with IGT or type 2 diabetes, with or without established CV disease. Eligible studies were required to have ≥ 500 participants and/or ≥ 100 endpoints of interest. Meta-analyses of available trial data were performed using random effects models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes and CV outcomes. Results Of ten trials identified, three met our inclusion criteria for incident type 2 diabetes and four were eligible for CV outcomes. The overall HR (95% CI) comparing AGI with placebo for incident type 2 diabetes was 0.77 (0.67–0.88), p < 0.0001, and for CV outcomes was 0.98 (0.89–1.10), p = 0.85. There was little to no heterogeneity between studies, with I2 values of 0.03% (p = 0.43) and 0% (p = 0.79) for the two outcomes respectively. Conclusions Allocation of people with IGT to an AGI significantly reduced their risk of incident type 2 diabetes by 23%, whereas in those with IGT or type 2 diabetes the impact on CV outcomes was neutral.

show abstract

“…In a meta-analysis, acarbose was also shown to delay the occurrence of myocardial infarction and other cardiovascular events in T2D [69]. It has been suggested that the STOP-NIDDM study lacked sufficient power to demonstrate cardiovascular benefits with acarbose due to the low number of cardiovascular events during the study [70,71]. In a recent large randomized, placebo-controlled trial of acarbose, the so-called ACE study, in Chinese patients with coronary heart disease and impaired glucose tolerance, as well as a recent meta-analysis including patients with impaired glucose tolerance or T2D, acarbose was reported to exhibit a neutral impact on cardiovascular events [15,72].…”

Section: Reducing the Rate Of Glucose Absorptionmentioning

confidence: 99%

Gastrointestinal Mechanisms Underlying the Cardiovascular Effect of Metformin

et al. 2020

View full text Add to dashboard Cite

Metformin, the most widely prescribed drug therapy for type 2 diabetes, has pleiotropic benefits, in addition to its capacity to lower elevated blood glucose levels, including mitigation of cardiovascular risk. The mechanisms underlying the latter remain unclear. Mechanistic studies have, hitherto, focused on the direct effects of metformin on the heart and vasculature. It is now appreciated that effects in the gastrointestinal tract are important to glucose-lowering by metformin. Gastrointestinal actions of metformin also have major implications for cardiovascular function. This review summarizes the gastrointestinal mechanisms underlying the action of metformin and their potential relevance to cardiovascular benefits.

show abstract

What does the Acarbose Cardiovascular Evaluation (ACE) trial tell us?

Cited by 4 publications

References 16 publications

Early or Late-Life Treatment With Acarbose or Rapamycin Improves Physical Performance and Affects Cardiac Structure in Aging Mice

Early or Late-Life Treatment With Acarbose or Rapamycin Improves Physical Performance and Affects Cardiac Structure in Aging Mice

Meta-analysis of the impact of alpha-glucosidase inhibitors on incident diabetes and cardiovascular outcomes

Gastrointestinal Mechanisms Underlying the Cardiovascular Effect of Metformin

Contact Info

Product

Resources

About