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Phosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality

ObjectiveExperimental evidence has shown potential cardioprotective actions of phosphodiesterase type-5 inhibitors (PDE5is). We investigated whether PDE5i use in patients with type 2 diabetes, with high-attendant cardiovascular risk, was associated with altered mortality in a retrospective cohort st... Full description

Journal Title: Heart 2016-11, Vol.102 (21), p.1750-1756
Main Author: Anderson, Simon G
Other Authors: Hutchings, David C , Woodward, Mark , Rahimi, Kazem , Rutter, Martin K , Kirby, Mike , Hackett, Geoff , Trafford, Andrew W , Heald, Adrian H
Format: Electronic Article Electronic Article
Language: English
Subjects:
1506
Abridged Index Medicus
Adult
Aged
Aged, 80 and over
Cardiac Risk Factors
Cardiac Risk Factors and Prevention
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - mortality
Cause of Death
Chi-Square Distribution
Databases, Factual
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - mortality
Electronic Health Records
England - epidemiology
Erectile Dysfunction - diagnosis
Erectile Dysfunction - drug therapy
Erectile Dysfunction - mortality
General Practice
Humans
Kaplan-Meier Estimate
Linear Models
Logistic Models
Male
Medical records
Middle Aged
Multivariate Analysis
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Patient outcomes
Phosphodiesterase 5 Inhibitors - therapeutic use
Phosphodiesterases
Prevention
Protective Factors
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Type 2 diabetes
Usage
Quelle: Alma/SFX Local Collection
Publisher: England: British Medical Association
ID: ISSN: 1355-6037
Link: https://www.ncbi.nlm.nih.gov/pubmed/27465053
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5099221
title: Phosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality
format: Article
creator:
  • Anderson, Simon G
  • Hutchings, David C
  • Woodward, Mark
  • Rahimi, Kazem
  • Rutter, Martin K
  • Kirby, Mike
  • Hackett, Geoff
  • Trafford, Andrew W
  • Heald, Adrian H
subjects:
  • 1506
  • Abridged Index Medicus
  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Risk Factors
  • Cardiac Risk Factors and Prevention
  • Cardiovascular Diseases - diagnosis
  • Cardiovascular Diseases - mortality
  • Cause of Death
  • Chi-Square Distribution
  • Databases, Factual
  • Diabetes Mellitus, Type 2 - diagnosis
  • Diabetes Mellitus, Type 2 - mortality
  • Electronic Health Records
  • England - epidemiology
  • Erectile Dysfunction - diagnosis
  • Erectile Dysfunction - drug therapy
  • Erectile Dysfunction - mortality
  • General Practice
  • Humans
  • Kaplan-Meier Estimate
  • Linear Models
  • Logistic Models
  • Male
  • Medical records
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction - diagnosis
  • Myocardial Infarction - mortality
  • Patient outcomes
  • Phosphodiesterase 5 Inhibitors - therapeutic use
  • Phosphodiesterases
  • Prevention
  • Protective Factors
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Type 2 diabetes
  • Usage
ispartof: Heart, 2016-11, Vol.102 (21), p.1750-1756
description: ObjectiveExperimental evidence has shown potential cardioprotective actions of phosphodiesterase type-5 inhibitors (PDE5is). We investigated whether PDE5i use in patients with type 2 diabetes, with high-attendant cardiovascular risk, was associated with altered mortality in a retrospective cohort study.Research design and methodsBetween January 2007 and May 2015, 5956 men aged 40–89 years diagnosed with type 2 diabetes before 2007 were identified from anonymised electronic health records of 42 general practices in Cheshire, UK, and were followed for 7.5 years. HRs from multivariable survival (accelerated failure time, Weibull) models were used to describe the association between on-demand PDE5i use and all-cause mortality.SM110.1136/heartjnl-2015-309223.supp1Supplementary appendixResultsCompared with non-users, men who are prescribed PDE5is (n=1359) experienced lower percentage of deaths during follow-up (19.1% vs 23.8%) and lower risk of all-cause mortality (unadjusted HR=0.69 (95% CI: 0.64 to 0.79); p
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
url: Link


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titlePhosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality
sourceAlma/SFX Local Collection
creatorAnderson, Simon G ; Hutchings, David C ; Woodward, Mark ; Rahimi, Kazem ; Rutter, Martin K ; Kirby, Mike ; Hackett, Geoff ; Trafford, Andrew W ; Heald, Adrian H
creatorcontribAnderson, Simon G ; Hutchings, David C ; Woodward, Mark ; Rahimi, Kazem ; Rutter, Martin K ; Kirby, Mike ; Hackett, Geoff ; Trafford, Andrew W ; Heald, Adrian H
descriptionObjectiveExperimental evidence has shown potential cardioprotective actions of phosphodiesterase type-5 inhibitors (PDE5is). We investigated whether PDE5i use in patients with type 2 diabetes, with high-attendant cardiovascular risk, was associated with altered mortality in a retrospective cohort study.Research design and methodsBetween January 2007 and May 2015, 5956 men aged 40–89 years diagnosed with type 2 diabetes before 2007 were identified from anonymised electronic health records of 42 general practices in Cheshire, UK, and were followed for 7.5 years. HRs from multivariable survival (accelerated failure time, Weibull) models were used to describe the association between on-demand PDE5i use and all-cause mortality.SM110.1136/heartjnl-2015-309223.supp1Supplementary appendixResultsCompared with non-users, men who are prescribed PDE5is (n=1359) experienced lower percentage of deaths during follow-up (19.1% vs 23.8%) and lower risk of all-cause mortality (unadjusted HR=0.69 (95% CI: 0.64 to 0.79); p<0.001)). The reduction in risk of mortality (HR=0.54 (0.36 to 0.80); p=0.002) remained after adjusting for age, estimated glomerular filtration rate, smoking status, prior cerebrovascular accident (CVA) hypertension, prior myocardial infarction (MI), systolic blood pressure, use of statin, metformin, aspirin and β-blocker medication. PDE5i users had lower rates of incident MI (incidence rate ratio (0.62 (0.49 to 0.80), p<0.0001) with lower mortality (25.7% vs 40.1% deaths; age-adjusted HR=0.60 (0.54 to 0.69); p=0.001) compared with non-users within this subgroup.ConclusionIn a population of men with type 2 diabetes, use of PDE5is was associated with lower risk of overall mortality and mortality in those with a history of acute MI.
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1EISSN: 1468-201X
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languageeng
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subject1506 ; Abridged Index Medicus ; Adult ; Aged ; Aged, 80 and over ; Cardiac Risk Factors ; Cardiac Risk Factors and Prevention ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - mortality ; Cause of Death ; Chi-Square Distribution ; Databases, Factual ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - mortality ; Electronic Health Records ; England - epidemiology ; Erectile Dysfunction - diagnosis ; Erectile Dysfunction - drug therapy ; Erectile Dysfunction - mortality ; General Practice ; Humans ; Kaplan-Meier Estimate ; Linear Models ; Logistic Models ; Male ; Medical records ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - diagnosis ; Myocardial Infarction - mortality ; Patient outcomes ; Phosphodiesterase 5 Inhibitors - therapeutic use ; Phosphodiesterases ; Prevention ; Protective Factors ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Type 2 diabetes ; Usage
ispartofHeart, 2016-11, Vol.102 (21), p.1750-1756
rights
0Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
1Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
2Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
3Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016
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1Hutchings, David C
2Woodward, Mark
3Rahimi, Kazem
4Rutter, Martin K
5Kirby, Mike
6Hackett, Geoff
7Trafford, Andrew W
8Heald, Adrian H
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descriptionObjectiveExperimental evidence has shown potential cardioprotective actions of phosphodiesterase type-5 inhibitors (PDE5is). We investigated whether PDE5i use in patients with type 2 diabetes, with high-attendant cardiovascular risk, was associated with altered mortality in a retrospective cohort study.Research design and methodsBetween January 2007 and May 2015, 5956 men aged 40–89 years diagnosed with type 2 diabetes before 2007 were identified from anonymised electronic health records of 42 general practices in Cheshire, UK, and were followed for 7.5 years. HRs from multivariable survival (accelerated failure time, Weibull) models were used to describe the association between on-demand PDE5i use and all-cause mortality.SM110.1136/heartjnl-2015-309223.supp1Supplementary appendixResultsCompared with non-users, men who are prescribed PDE5is (n=1359) experienced lower percentage of deaths during follow-up (19.1% vs 23.8%) and lower risk of all-cause mortality (unadjusted HR=0.69 (95% CI: 0.64 to 0.79); p<0.001)). The reduction in risk of mortality (HR=0.54 (0.36 to 0.80); p=0.002) remained after adjusting for age, estimated glomerular filtration rate, smoking status, prior cerebrovascular accident (CVA) hypertension, prior myocardial infarction (MI), systolic blood pressure, use of statin, metformin, aspirin and β-blocker medication. PDE5i users had lower rates of incident MI (incidence rate ratio (0.62 (0.49 to 0.80), p<0.0001) with lower mortality (25.7% vs 40.1% deaths; age-adjusted HR=0.60 (0.54 to 0.69); p=0.001) compared with non-users within this subgroup.ConclusionIn a population of men with type 2 diabetes, use of PDE5is was associated with lower risk of overall mortality and mortality in those with a history of acute MI.
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11Databases, Factual
12Diabetes Mellitus, Type 2 - diagnosis
13Diabetes Mellitus, Type 2 - mortality
14Electronic Health Records
15England - epidemiology
16Erectile Dysfunction - diagnosis
17Erectile Dysfunction - drug therapy
18Erectile Dysfunction - mortality
19General Practice
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21Kaplan-Meier Estimate
22Linear Models
23Logistic Models
24Male
25Medical records
26Middle Aged
27Multivariate Analysis
28Myocardial Infarction - diagnosis
29Myocardial Infarction - mortality
30Patient outcomes
31Phosphodiesterase 5 Inhibitors - therapeutic use
32Phosphodiesterases
33Prevention
34Protective Factors
35Retrospective Studies
36Risk Assessment
37Risk Factors
38Time Factors
39Treatment Outcome
40Type 2 diabetes
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titlePhosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality
authorAnderson, Simon G ; Hutchings, David C ; Woodward, Mark ; Rahimi, Kazem ; Rutter, Martin K ; Kirby, Mike ; Hackett, Geoff ; Trafford, Andrew W ; Heald, Adrian H
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01506
1Abridged Index Medicus
2Adult
3Aged
4Aged, 80 and over
5Cardiac Risk Factors
6Cardiac Risk Factors and Prevention
7Cardiovascular Diseases - diagnosis
8Cardiovascular Diseases - mortality
9Cause of Death
10Chi-Square Distribution
11Databases, Factual
12Diabetes Mellitus, Type 2 - diagnosis
13Diabetes Mellitus, Type 2 - mortality
14Electronic Health Records
15England - epidemiology
16Erectile Dysfunction - diagnosis
17Erectile Dysfunction - drug therapy
18Erectile Dysfunction - mortality
19General Practice
20Humans
21Kaplan-Meier Estimate
22Linear Models
23Logistic Models
24Male
25Medical records
26Middle Aged
27Multivariate Analysis
28Myocardial Infarction - diagnosis
29Myocardial Infarction - mortality
30Patient outcomes
31Phosphodiesterase 5 Inhibitors - therapeutic use
32Phosphodiesterases
33Prevention
34Protective Factors
35Retrospective Studies
36Risk Assessment
37Risk Factors
38Time Factors
39Treatment Outcome
40Type 2 diabetes
41Usage
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0Anderson, Simon G
1Hutchings, David C
2Woodward, Mark
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4Rutter, Martin K
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8Heald, Adrian H
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atitlePhosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality
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seriestitleOriginal article
date2016-11
risdate2016
volume102
issue21
spage1750
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pages1750-1756
issn1355-6037
eissn1468-201X
notesSGA and DCH contributed equally to this study.
abstractObjectiveExperimental evidence has shown potential cardioprotective actions of phosphodiesterase type-5 inhibitors (PDE5is). We investigated whether PDE5i use in patients with type 2 diabetes, with high-attendant cardiovascular risk, was associated with altered mortality in a retrospective cohort study.Research design and methodsBetween January 2007 and May 2015, 5956 men aged 40–89 years diagnosed with type 2 diabetes before 2007 were identified from anonymised electronic health records of 42 general practices in Cheshire, UK, and were followed for 7.5 years. HRs from multivariable survival (accelerated failure time, Weibull) models were used to describe the association between on-demand PDE5i use and all-cause mortality.SM110.1136/heartjnl-2015-309223.supp1Supplementary appendixResultsCompared with non-users, men who are prescribed PDE5is (n=1359) experienced lower percentage of deaths during follow-up (19.1% vs 23.8%) and lower risk of all-cause mortality (unadjusted HR=0.69 (95% CI: 0.64 to 0.79); p<0.001)). The reduction in risk of mortality (HR=0.54 (0.36 to 0.80); p=0.002) remained after adjusting for age, estimated glomerular filtration rate, smoking status, prior cerebrovascular accident (CVA) hypertension, prior myocardial infarction (MI), systolic blood pressure, use of statin, metformin, aspirin and β-blocker medication. PDE5i users had lower rates of incident MI (incidence rate ratio (0.62 (0.49 to 0.80), p<0.0001) with lower mortality (25.7% vs 40.1% deaths; age-adjusted HR=0.60 (0.54 to 0.69); p=0.001) compared with non-users within this subgroup.ConclusionIn a population of men with type 2 diabetes, use of PDE5is was associated with lower risk of overall mortality and mortality in those with a history of acute MI.
copEngland
pubBritish Medical Association
pmid27465053
doi10.1136/heartjnl-2015-309223
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