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The ACE trial:a new perspective on the effect of acarbose on cardiovascular outcomes
The Acarbose Cardiovascular Evaluation ( ACE ) trial assessed whether acarbose could reduce the incidence of cardiovascular event ( CVE) s in Chinese patients suffering from impaired glucose tolerance ( IGT) and coronary heart disease. ACE differs from a previous study on IGT people, the Study to Prevent Non-Insulin-Dependent Diabetes Mellitus ( STOP-NIDDM) trial in terms of sample size, number of CVE, mean age, acarbose dose, and population. ACE supported STOP-NIDDM's results by showing that acarbose prevents the progression of prediabetes to diabetes in IGT people, and extended the effect to people with coronary heart disease. However it did not reduce CVE incidence, probably due to the low dose used (50 mg tid). Overall, ACE is well-designed and high-powered enough to confirm that acarbose can prevent progression of prediabetes to diabetes, but is not able to reduce CVE incidence. However, in light of the fast growing prediabetic Chinese population, usage of acarbose is warranted to avert an explosion of diabetes.
