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Rationale for and design of the Acarbose Cardiovascular Evaluation (ACE) trial

Rury R Holman1, Mary A Bethel1, Juliana C N Chan2

  • 1Diabetes Trials Unit, University of Oxford, Oxford, United Kingdom.

American Heart Journal
|June 23, 2014
PubMed

Insights

Patients with cardiovascular disease and impaired glucose tolerance face higher risks. Acarbose may reduce type 2 diabetes mellitus (T2DM) risk and potentially cardiovascular risk in this population.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Patients with cardiovascular disease (CVD) and impaired glucose tolerance (IGT) have elevated risks for cardiovascular events and type 2 diabetes mellitus (T2DM).
  • Current interventions like lifestyle changes or medications can delay T2DM onset but lack definitive evidence for reducing cardiovascular risk in this specific group.

Purpose of the Study:

  • To evaluate the potential of acarbose, an alpha-glucosidase inhibitor, in mitigating cardiovascular risk within the high-risk population of patients with CVD and IGT.

Main Methods:

  • Acarbose, known for lowering postprandial blood glucose, was investigated for its effects on cardiovascular risk.
  • Previous studies demonstrated a 25% reduction in T2DM risk with acarbose and suggested possible cardiovascular benefits in IGT subjects without pre-existing CVD.

Main Results:

  • Acarbose effectively lowers postprandial blood glucose levels.
  • The drug has a proven track record of reducing the risk of developing T2DM by 25% in individuals with IGT.
  • Emerging evidence suggests a potential benefit in reducing cardiovascular risk, particularly in individuals with IGT but without established cardiovascular disease.

Conclusions:

  • Acarbose is a promising therapeutic option for patients with cardiovascular disease and impaired glucose tolerance.
  • It demonstrates efficacy in delaying the progression to type 2 diabetes mellitus.
  • Further research is warranted to confirm its cardiovascular risk reduction benefits in this vulnerable patient cohort.

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