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| Name | Class |
|---|---|
| Dong-A ST Co., Ltd. | INDUSTRY |
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The goal of this observational study is to compare severity and mortality rates of acute cerebral infarction(requiring thrombolysis or endovascular recanalization) depending on the type of oral antidiabetic drug taken before the onset of cerebral infarction.
Researchers will compare the group that used DPP-4 inhibitors as anti-diabetic drugs before cerebral infarction and the group that did not use them to see the effect of DPP-4 inhibitors in reducing severity of cerebral infarction.
This is a retrospective study to see the effects of reducing the severity of cerebral infarction(requiring thrombolysis or endovascular recanalization) of DPP-4 inhibitors by comparing the survival rate after acute cerebral infarction hospitalization, discharge rate to home, and medical cost.
A. Severity of cerebral infarction and poor prognosis is mainly associated with hyperglycemia caused by diabetes, which increases the Infarction volume and hemorrhagic trasformation.
B. However, the effect of loergin blood glucose on reducing the Infarction volume and improving prognosis of cerebral infarction has not been proven.
C. Preclinical studies have demonstrated a anti-stroke effect that reduces the Infarction volume using certain anti-diabetic drugs.
D. Therefore, there is a possibility that certain anti-diabetic drugs may reduce the severity of cerebral infarction as a class effect in addition to the effect of blood sugar control.
E. This is particularly likely to exist in the DPP-4 inhibitor family identified through preclinical studies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DPP4i | used DPP-4 inhibitors as anti-diabetic drugs before cerebral infarction(requiring thrombolysis or endovascular recanalization) Combination therpay is acceptable. |
| |
| except DPP4i | patients that did not use DPP-4 inhibitors as anti-diabetic drugs before cerebral infarction(requiring thrombolysis or endovascular recanalization) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dipeptidyl peptidase-4 inhibitor | Drug | The definition of antidiabetic drug use is defined as a case in which an antidiabetic drug was prescribed for at least 2 months before stroke and the duration of treatment for stroke coincided with the prescribed duration of the drug. |
| Measure | Description | Time Frame |
|---|---|---|
| 1-year survival rate | The survival rates of the DPP-4 inhibitor group and the non-use group are compared 1 year after the onset of severe stroke. | Check the data one year after the onset of stroke. |
| 90-day survival rate | The survival rates of the DPP-4 inhibitor group and the non-use group are compared 90-day after the onset of severe stroke. | Check the data 90-day after the onset of stroke. |
| re-hospitalization | The re-hospitalization rates of the DPP-4 inhibitor group and the non-use group are compared after the onset of severe stroke. | 1 year after discharge the stroke treatment. |
| frequency of cerebral hemorrhage | The frequency of cerebral hemorrhage rates of the DPP-4 inhibitor group and the non-use group are compared after the onset of severe stroke. | Hospitalization period and 1 year after discharge the stroke treatment. |
| Rate of Intensive care unit treatment | The Intensive care unit treatment rate of the DPP-4 inhibitor group and the non-use group are compared. | Hospitalization period is expected to be up to three months. It is not possible to accurately estimate the period of hospitalization due to severe stroke. |
| Duration of Intensive care unit | The duration of Intensive care unit of the DPP-4 inhibitor group and the non-use group are compared. | Hospitalization period is expected to be up to three months. It is not possible to accurately estimate the period of hospitalization due to severe stroke. |
| Measure | Description | Time Frame |
|---|---|---|
| Home discharge rate | The Home discharge rate of the DPP-4 inhibitor group and the non-use group are compared. | At the end of discharge from stroke treatment. |
| medical expenses after discharge from hospital |
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Inclusion Criteria:
Patients with acute cerebral infarction who underwent thrombolysis or endovascular recanalization in Korea between 2014 and 2021
Those who have been previously diagnosed with diabetes and are taking oral anti-diabetic drugs
Adult (over 19 years of age)
Exclusion Criteria:
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This is a retrospective study using the Health Insurance Review and Assessment Service (HIRA) database in Korea.
In this database, patients with acute cerebral infarction who underwent thrombolysis(intravenous thrombolysis) or endovascular recanalization (intraarterial thrombectomy) between 2014 and 2021 is included.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| SooJung Kim | Contact | 82-31-219-6773 | 438104@gmail.com | |
| Seong-Joon Lee, MD., PhD. | Contact | 82-31-219-4912 | editisan@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| DukYong Yoon, MD., PhD. | Department of Biomedical Systems Informatics,Yonsei University College of Medicine,Yongin,SouthKorea | Principal Investigator |
| Seong-Joon Lee, MD., PhD. | Department of Neurology, Ajou University School of Medicine, Suwon, South Korea |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30794833 | Result | Sinha B, Ghosal S. Meta-analyses of the effects of DPP-4 inhibitors, SGLT2 inhibitors and GLP1 receptor analogues on cardiovascular death, myocardial infarction, stroke and hospitalization for heart failure. Diabetes Res Clin Pract. 2019 Apr;150:8-16. doi: 10.1016/j.diabres.2019.02.014. Epub 2019 Feb 20. | |
| 23209191 | Result |
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Ajou University Hospital's IRB(Institutional Review Board) sends IRB approval documents to HIRA and conducts research with anonymized data after request.
Data collected during the research process will be stored for 3 years and then properly disposed of in accordance with relevant laws.
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| ID | Term |
|---|---|
| D002544 | Cerebral Infarction |
| D020520 | Brain Infarction |
| ID | Term |
|---|---|
| D002545 | Brain Ischemia |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D054873 | Dipeptidyl-Peptidase IV Inhibitors |
| C557982 | 4-(3-amino-4-(2,4,5-trifluorophenyl)butanoyl)-3-(tert-butoxymethyl)piperazin-2-one |
| ID | Term |
|---|---|
| D011480 | Protease Inhibitors |
| D004791 | Enzyme Inhibitors |
| D045504 | Molecular Mechanisms of Pharmacological Action |
| D020228 | Pharmacologic Actions |
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|
| Rate of Stroke care unit treatment | The Stroke care unit treatment rate of the DPP-4 inhibitor group and the non-use group are compared. | Hospitalization period is expected to be up to three months. It is not possible to accurately estimate the period of hospitalization due to severe stroke. |
| Duration of Stroke care unit | The duration of Stroke care unit of the DPP-4 inhibitor group and the non-use group are compared. | Hospitalization period is expected to be up to three months. It is not possible to accurately estimate the period of hospitalization due to severe stroke. |
| tracheal intubation period | The tracheal intubation period of the DPP-4 inhibitor group and the non-use group are compared. | Hospitalization period is expected to be up to three months. It is not possible to accurately estimate the period of hospitalization due to severe stroke. |
| total hospitalization days | The total hospitalization days of the DPP-4 inhibitor group and the non-use group are compared. | Hospitalization period is expected to be up to three months. It is not possible to accurately estimate the period of hospitalization due to severe stroke. |
| medical expenses incurred at the time of hospitalization | The medical expenses incurred at the time of hospitalization of the DPP-4 inhibitor group and the non-use group are compared. | Hospitalization period is expected to be up to three months. It is not possible to accurately estimate the period of hospitalization due to severe stroke. |
The medical expenses after discharge from hospital of the DPP-4 inhibitor group and the non-use group are compared.
| 1 year after discharge the stroke treatment. |
| Darsalia V, Ortsater H, Olverling A, Darlof E, Wolbert P, Nystrom T, Klein T, Sjoholm A, Patrone C. The DPP-4 inhibitor linagliptin counteracts stroke in the normal and diabetic mouse brain: a comparison with glimepiride. Diabetes. 2013 Apr;62(4):1289-96. doi: 10.2337/db12-0988. Epub 2012 Dec 3. |
| 34780772 | Result | Lee SJ, Yoon BS, Hong JM, Joe EH, Lee JS. Effects of co-administration of metformin and evogliptin on cerebral infarct volume in the diabetic rat. Exp Neurol. 2022 Feb;348:113922. doi: 10.1016/j.expneurol.2021.113922. Epub 2021 Nov 12. |
| 31334795 | Result | Johnston KC, Bruno A, Pauls Q, Hall CE, Barrett KM, Barsan W, Fansler A, Van de Bruinhorst K, Janis S, Durkalski-Mauldin VL; Neurological Emergencies Treatment Trials Network and the SHINE Trial Investigators. Intensive vs Standard Treatment of Hyperglycemia and Functional Outcome in Patients With Acute Ischemic Stroke: The SHINE Randomized Clinical Trial. JAMA. 2019 Jul 23;322(4):326-335. doi: 10.1001/jama.2019.9346. |
| 30558400 | Result | Kim JY, Kang K, Kang J, Koo J, Kim DH, Kim BJ, Kim WJ, Kim EG, Kim JG, Kim JM, Kim JT, Kim C, Nah HW, Park KY, Park MS, Park JM, Park JH, Park TH, Park HK, Seo WK, Seo JH, Song TJ, Ahn SH, Oh MS, Oh HG, Yu S, Lee KJ, Lee KB, Lee K, Lee SH, Lee SJ, Jang MU, Chung JW, Cho YJ, Choi KH, Choi JC, Hong KS, Hwang YH, Kim SE, Lee JS, Choi J, Kim MS, Kim YJ, Seok J, Jang S, Han S, Han HW, Hong JH, Yun H, Lee J, Bae HJ. Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society. J Stroke. 2019 Jan;21(1):42-59. doi: 10.5853/jos.2018.03125. Epub 2018 Dec 18. |
| 33502058 | Result | Park SH, Jeong HE, Oh IS, Hong SM, Yu SH, Lee CB, Shin JY. Cardiovascular safety of evogliptin in patients with type 2 diabetes: A nationwide cohort study. Diabetes Obes Metab. 2021 Jun;23(6):1232-1241. doi: 10.1111/dom.14330. Epub 2021 Feb 10. |
| 32027799 | Result | Shim DH, Kim Y, Roh J, Kang J, Park KP, Cha JK, Baik SK, Kim Y. Hospital Volume Threshold Associated with Higher Survival after Endovascular Recanalization Therapy for Acute Ischemic Stroke. J Stroke. 2020 Jan;22(1):141-149. doi: 10.5853/jos.2019.00955. Epub 2020 Jan 31. |
| D009422 | Nervous System Diseases |
| D020521 | Stroke |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |
| D020164 | Chemical Actions and Uses |
| D007004 | Hypoglycemic Agents |
| D045505 | Physiological Effects of Drugs |