Coronary Heart DiseasePhase 4ACENCT00829660
Acarbose Cardiovascular Evaluation Trial
A Phase 4 study testing Acarbose in people with Coronary Heart Disease and Acute Coronary Syndrome, run by University of Oxford at 177 sites in 2 countries.
Trial summary
The purpose of this study is to determine whether acarbose therapy can reduce cardiovascular-related morbidity and mortality in patients with impaired glucose tolerance (IGT) who have established coronary heart disease (CHD) or acute coronary syndrome (ACS). Read more about this study
- Who is it for?
- Ages 50 years and older
- Conditions the study is for
- Coronary Heart Disease, Acute Coronary Syndrome, Impaired Glucose Tolerance
- What is being tested?
- Acarbose
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 6,526 participants
- Where
- 177 sitesin 2 countries
- Study dates
- 17 Feb 2009to 18 Apr 2017
- Phase
- Phase 4
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 50 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male or female, aged 50 years or more.
- Definite CHD, defined as a, b or c below:
- Previous myocardial infarction (MI) or Acute Coronary Syndrome (ACS), but not within the last 3 months, with any two of the following:
- Typical clinical presentation
- Confirmatory ECG changes
- Appropriate elevation of cardiac enzymes/biomarkers
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- Previous unstable angina (UA) or Acute Coronary Syndrome (ACS), but not within the last 3 months, with any two of the following:
- Typical clinical presentation
- Confirmatory ECG changes
- Either elevation of a cardiac biomarker or a >50% stenosis in ≥1 major epicardial coronary artery shown on coronary angiography or CT angiography. Where stenosis is reported in a qualitative manner, the categories "moderate" and "severe" will be taken as equating to >50% stenosis.
- Current stable angina defined as:
- Typical clinical history with symptoms occurring within the last month, and
- A >50% stenosis in ≥1 major epicardial coronary artery shown on coronary angiography or CT angiography. Where stenosis is reported in a qualitative manner, the categories "moderate" and "severe" will be taken as equating to >50% stenosis.
- Impaired glucose tolerance diagnosed on a single standard oral glucose tolerance test (OGTT) , defined as a 2-hour plasma glucose (2HPG) value ≥7.8 but <11.1 mmol/l and a fasting plasma glucose (FPG) <7.0 mmol/l within six months prior to enrollment.
- Optimised cardiovascular drug therapy.
- At least 80% adherent to single blind placebo Study Medication during the run-in period.
- Provision of written informed consent.
Who cannot join
- Previous history of diabetes, other than gestational diabetes.
- MI, unstable angina, stroke or a transient ischaemic attack (TIA) within the previous three months.
- Planned or anticipated coronary, cerebrovascular or peripheral arterial revascularisation or other major surgical intervention, at the time of randomisation
- New York Heart Association (NYHA) class III or IV heart failure.
- Evidence of severe hepatic disease.
- Evidence of severe renal impairment or an eGFR <30 ml/min/1.73m2 (derived using the Modification of Diet in Renal Disease, MDRD, Chinese equation)
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- Any other condition likely to reduce adherence to the protocol e.g. alcoholism, major active psychiatric disorder, cognitive impairment or a condition likely to markedly limit life expectancy e.g. malignancy.
- Pregnancy (or planned pregnancy within the next five years).
- Concurrent participation in any other clinical interventional trial. Note: Patients who were treated previously with an alphaglucosidase inhibitor must have at least a three-month washout period before being randomised into the ACE trial.
- Known intolerance to alpha glucosidase inhibitors or gastrointestinal problems.
- Thought by the investigator for any reason to be unsuitable for participation in this clinical study.
Trial locations and contacts
177 sites in 2 countries.
177 sites in 2 countries
China176 sites
The Central Hospital of Anshan
Anshan, Liaoning, 114001
The First Affiliated Hospital of Baotou Medical College
Baotou, Inner Mongolia, 014010
Baotou Central Hospital
Baotou, Inner Mongolia, 014040
Beijing Chuiyangliu Hospital
Beijing, Beijing Municipality, 100022
China Meitan General Hospital
Beijing, Beijing Municipality, 100028
Beijing Anzhen Hospital of The Capital University of Medical Sciences
Beijing, Beijing Municipality, 100029
China-Japan Friendship Hospital
Beijing, Beijing Municipality, 100029
Peking University First Hospital
Beijing, Beijing Municipality, 100034
Beijing Ji Shui Tan Hospital
Beijing, Beijing Municipality, 100035
Beijing Shijitan Hospital
Beijing, Beijing Municipality, 100038
Fu Xing Hospital
Beijing, Beijing Municipality, 100038
Beijing Shijingshan Hospital
Beijing, Beijing Municipality, 100043
Peking University People's Hospital
Beijing, Beijing Municipality, 100044
Aerospace Central Hospital
Beijing, Beijing Municipality, 100049
Affiliated to The Capital University of Medical Sciences Beijing Friendship Hospital
Beijing, Beijing Municipality, 100050
Wangjing Hospital of CACMS
Beijing, Beijing Municipality, 100053
Xuanwu Hospital Capital Medical University
Beijing, Beijing Municipality, 100053
Beijing Healthy Palace Hospital
Beijing, Beijing Municipality, 100054
Aerospace 731 Hospital
Beijing, Beijing Municipality, 100074
General Hospital of Second Artillery PLA
Beijing, Beijing Municipality, 100088
Peking Union Medical College Hospital
Beijing, Beijing Municipality, 100730
PLA General Hospital
Beijing, Beijing Municipality, 100853
Anzhen Hospital of The Capital University of Medical Sciences 2nd.
Beijing, Beijing Municipality, 101200
Beijing Pinggu Hospital
Beijing, Beijing Municipality, 101200
Beijing Yanhua Hospital
Beijing, Beijing Municipality, 102500
Cangzhou Central Hospital
Cangzhou, Hebei, 062650
China-Japan Union Hospital of Jilin University
Changchun, Jilin, 130033
The Second Hospital of Jilin University
Changchun, Jilin, 130041
Hunan Provincial People's Hospital
Changsha, Hunan, 410005
The Fourth Hospital of Changsha
Changsha, Hunan, 410006
Xiangya Hospital Central-South University
Changsha, Hunan, 410008
The Third Hospital of Changsha
Changsha, Hunan, 410015
Chengdu First People's Hospital
Chengdu, Sichuan, 610016
Chengdu Second People's Hospital
Chengdu, Sichuan, 610017
Sichuan Provincial People's Hospital
Chengdu, Sichuan, 610041
The West China Hospital
Chengdu, Sichuan, 610041
Chifeng Municipal Hospital
Chifeng, Inner Mongolia, 024000
Chongqing Medical University Second Afflicated Hospital
Chongqing, Chongqing Municipality, 400010
Chongqing Zhongshan Hospital
Chongqing, Chongqing Municipality, 400013
Chongqing Third People's Hospital
Chongqing, Chongqing Municipality, 400014
The First Affiliated Hospital of Chongqing Medical University
Chongqing, Chongqing Municipality, 400016
Da Ping Hospital
Chongqing, Chongqing Municipality, 400042
The Second People's Hospital of Chongqing
Chongqing, Chongqing Municipality, 402160
Affiliated Zhongshan Hospital of Dalian University
Dalian, Liaoning, 116001
The First Hospital of Dalian Medical University
Dalian, Liaoning, 116011
Dalian Central Hospital
Dalian, Liaoning, 116033
Da Qing Oilfield General Hospital
Daqing, Heilongjiang, 163001
Fujian Provincial Hospital
Fuzhou, Fujian, 350001
Union Hospital Affiliated to Fujian Medical University
Fuzhou, Fujian, 350001
The People's Hospital of Fujian Province
Fuzhou, Fujian, 350004
Guangdong General Hospital
Guangzhou, Guangdong, 510080
The First Affiliated Hospital of Guangdong Pharmaceutical University
Guangzhou, Guangdong, 510080
The First Affiliated Hospital of Sun Yat-Sen University
Guangzhou, Guangdong, 510080
Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
Guangzhou, Guangdong, 510120
The Third Affiliated Hospital of Guangzhou Medical College
Guangzhou, Guangdong, 510150
Wu Jing Zhong Dui Hospital of Guangdong Province
Guangzhou, Guangdong, 510507
The First Affiliated Hospital of Jinan University
Guangzhou, Guangdong, 510630
The Affiliated Hospital of Guiyang Medical College
Guiyang, Guizhou, 550004
Zhe Jiang Hospital
Hangzhou, Zhejiang, 310013
Sir Run Run Shaw Hospital Affiliated With School of Medicine, Zhe Jiang University
Hangzhou, Zhejiang, 310016
The Fourth Affiliated Hospital of Harbin Medical University
Harbin, Heilongjiang, 150001
The First Affiliated Hospital of Anhui Medical University
Hefei, Anhui, 230032
Inner Mongolia Hospital
Hohhot, Inner Mongolia, 010017
The Central Hospital of Jinan
Jinan, Shandong, 250013
The First People's Hospital of Jinan
Jinan, Shandong, 250013
The General Hospital of Jinan Military Region
Jinan, Shandong, 250031
Jiujiang University Hospital
Jiujiang, Jiangxi, 332000
The First Affiliated Hospital of Kunming Medical College
Kunming, Yunnan, 650032
The First People's Hospital of Yunnan Province
Kunming, Yunnan, 650032
The Second Affiliated Hospital of Kunming Medical College
Kunming, Yunnan, 650101
Linyi People's Hospital
Linyi, Shandong, 276003
Liuzhou Worker's Hospital
Liuzhou, Guangxi, 545005
Liuzhou People's Hospital
Liuzhou, Guangxi, 545006
The First Affiliated Hospital of Henan Science & Technology University
Luoyang, Henan, 471003
Luo Yang Central Hospital, Affiliated to Zhengzhou University
Luoyang, Henan, 471009
Jiangxi Provincial People's Hospital
Nanchang, Jiangxi, 330006
The Second Affiliated Hospital of Nanchang University
Nanchang, Jiangxi, 330006
The Third Affiliated Hospital of Nanchang University
Nanchang, Jiangxi, 330008
81st Hospital of Chinese PLA
Nanjing, Jiangsu, 210002
Nanjing First Hospital
Nanjing, Jiangsu, 210006
Nanjing Drum Tower Hospital
Nanjing, Jiangsu, 210008
Nanjing Zhongda Hospital
Nanjing, Jiangsu, 210009
BENQ Hospital
Nanjing, Jiangsu, 210017
Jiangsu Province Official Hospital
Nanjing, Jiangsu, 210024
Jiangsu Province Hospital
Nanjing, Jiangsu, 210029
Jiangsu Provincial Hospital of TCM
Nanjing, Jiangsu, 210029
Nanjing Jiangning Hospital
Nanjing, Jiangsu, 211100
Minzu Hospital of Guangxi Zhuang Autonomous Region
Nanning, Guangxi, 530001
303 Hospital of People's Liberation Army
Nanning, Guangxi, 530021
The First Affiliated Hospital of Guangxi Medical University
Nanning, Guangxi, 530021
Hospital Affiliated of Medical School, Qingdao University
Qingdao, Shandong, 266003
The Qingdao Municiple Hospital
Qingdao, Shandong, 266011
Shanghai Ninth People's Hospital
Shanghai, Shanghai Municipality, 200011
Ruijin Hospital Affiliated to the Shanghai Jiaotong University Medical School
Shanghai, Shanghai Municipality, 200025
Shanghai Central Hospital of Xuhui District
Shanghai, Shanghai Municipality, 200031
Shanghai Zhongshan Hospital
Shanghai, Shanghai Municipality, 200032
Shanghai Huadong Hospital
Shanghai, Shanghai Municipality, 200040
Shanghai Putuo District People's Hospital
Shanghai, Shanghai Municipality, 200060
Putuo District Center Hospital
Shanghai, Shanghai Municipality, 200062
Tongji Hospital of Tongji University
Shanghai, Shanghai Municipality, 200065
Shanghai Tenth People's Hospital
Shanghai, Shanghai Municipality, 200072
Number 411 Hospital of PLA
Shanghai, Shanghai Municipality, 200081
Shanghai Central Hospital of Yangpu District
Shanghai, Shanghai Municipality, 200090
Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine
Shanghai, Shanghai Municipality, 200092
Shanghai East Hospital
Shanghai, Shanghai Municipality, 200120
Renji Hospital Affilicated to Jiaotong University School of Medicine
Shanghai, Shanghai Municipality, 200127
Shanghai Pudong New Area Gongli Hospital
Shanghai, Shanghai Municipality, 200135
Changhai Hospital
Shanghai, Shanghai Municipality, 200433
Shanghai Zhabei District Shibei Hospital
Shanghai, Shanghai Municipality, 200435
Shanghai Jinshan Hospital
Shanghai, Shanghai Municipality, 200540
Shanghai Pudong New District People's Hospital
Shanghai, Shanghai Municipality, 201200
Xianyang Central Hospital
Shengyang, Liaoning, 712000
Shengjing Hospital of China Medical University
Shenyang, Liaoning, 110004
The People's Hospital of Liaoning Province
Shenyang, Liaoning, 110016
Shengjing Hospital of China Medical University
Shenyang, Liaoning, 110021
The Fourth Hospital of China Medical University
Shenyang, Liaoning, 110032
Peking University Shenzhen Hospital
Shenzhen, Guangdong, 518036
Qingdao Fuwai Hospital
Shibei, Shandong, 266034
First Affiliated Hospital of the Medical College
Shihezi, Xinjiang, 832008
The Second Hospital of Hebei Medical University
Shijiazhuang, Hebei, 050000
The First Hospital of Hebei Medical University
Shijiazhuang, Hebei, 050031
Bethune International Peace Hospital
Shijiazhuang, Hebei, 050082
Sichuan Mianyang 404 Hospital
Sichuan, Sichuan, 621000
Suzhou Municipal Hospital
Suzhou, Jiangsu, 215000
Taian City Central Hospital
Taian, Shandong, 271000
General Hospital of Tisco
Taiyuan, Shanxi, 030003
The Third Engineering Bureau Hospital of Ministry of Railway
Taiyuan, Shanxi, 030006
Taiyuan City Central Hospital
Taiyuan, Shanxi, 030009
Shanxi Cardiovascular Hospital
Taiyuan, Shanxi, 030024
Tangshan Workers Hospital
Tangshan, Hebei, 063000
The Affiliated Hospital of North China Coal Medical University
Tangshan, Hebei, 063000
Yu Tian County Hospital
Tangshan, Hebei, 064100
Tianjin Union Hospital
Tianjin, Tianjin Municipality, 300050
Tianjin Chest Hospital
Tianjin, Tianjin Municipality, 300051
Tianjin Union Medicine Centre
Tianjin, Tianjin Municipality, 300121
Army Police's Medical College Affiliated Hospital
Tianjin, Tianjin Municipality, 300162
Tianjin Third Central Hospital
Tianjin, Tianjin Municipality, 300170
Tianjin First Center Hospital
Tianjin, Tianjin Municipality, 300192
The Second Hospital of Tianjin Medical University
Tianjin, Tianjin Municipality, 300211
Dagang Oil-Field General Hospital
Tianjin, Tianjin Municipality, 300280
The Fifth Central Hospital of Tianjin
Tianjin, Tianjin Municipality, 300450
Xin Jiang Traditional Chinese Medicine Hospital
Ürümqi, Xinjiang, 830000
General Hospital of Xinjiang Production and Construction Corps
Ürümqi, Xinjiang, 830002
The 474th Hospital of PLA
Ürümqi, Xinjiang, 830013
The First Teaching Hospital of Xinjiang Medical University
Ürümqi, Xinjiang, 830054
Union Hospital of Tongji Medical College of Huazhong
Wuhan, Hubei, 430022
Wuhan Asia Heart Hospital
Wuhan, Hubei, 430022
Tongji Hospital of Tongji Medical College of Huazhong
Wuhan, Hubei, 430030
Pu'ai Hospital of Wuhan City
Wuhan, Hubei, 430033
Renmin Hospital of Wuhan University
Wuhan, Hubei, 430060
Zhongnan Hospital of Wuhan University
Wuhan, Hubei, 430071
Wuxi No.2 People's Hospital
Wuxi, Jiangsu, 214002
Wuxi People's Hospital
Wuxi, Jiangsu, 214023
Wuxi No.3 People's Hospital
Wuxi, Jiangsu, 214041
Xi'an Central Hospital
Xi'an, Shaanxi, 710003
The First Affiliated Hospital of Xi'an Jiaotong University
Xi'an, Shaanxi, 710061
Affiliated Hospital of Xi'an Medical college
Xi'an, Shaanxi, 710077
PLA No.323 Hospital
Xi’an, Shanxi, 710054
The First Hospital of Xiamen
Xiamen, Fujian, 361003
Zhongshan Hospital Xiamen University
Xiamen, Fujian, 361004
Hospital Affiliated Xuzhou Medical University
Xuzhou, Jiangsu, 221000
The Second Affiliated Hospital of Xuzhou Medical University
Xuzhou, Jiangsu, 221006
Affiliated Hospital of Yan'an University
Yan’an, Shaanxi, 716000
Yan'an People's Hospital
Yan’an, Shaanxi, 716000
The First Hospital of Yinchuan
Yinchuan, Ningxia, 750001
Affiliated Hospital of Ningxia Medical University
Yinchuan, Ningxia, 750004
The People's Hospital of Ningxia Hui Autonomous Region
Yinchuan, Ningxia, 750021
The First Hospital of Yulin
Yulin, Shaanxi, 719000
People's Hospital of Yuxi City
Yuxi, Yunnan, 653100
The Third Affiliated Hospital of Hebei North University
Zhangjiakou, Hebei, 075000
The First Affiliated Hospital of Henan College of TCM
Zhengzhou, Henan, 450000
The People's Hospital of Zhengzhou
Zhengzhou, Henan, 450003
The Second Affiliated Hospital of Zhengzhou University
Zhengzhou, Henan, 450014
Zhenjiang First People's Hospital
Zhenjiang, Jiangsu, 212002
Zhong Shan City People's Hospital
Zhongshan, Guangdong, 528403
The Fifth Affiliated Hospital of Sun Yat-Sen University
Zhuhai, Guangdong, 519000
About this study
Official title: A Long-term, Multicentre, Double-blind, Randomised Parallel-group Trial to Determine Whether Reducing Post-prandial Glycaemia Can Reduce Cardiovascular-related Morbidity and Mortality in Patients With Established Coronary Heart Disease or Acute Coronary Syndrome Who Have Impaired Glucose Tolerance
The purpose of this study is to determine whether acarbose therapy can reduce cardiovascular-related morbidity and mortality in patients with impaired glucose tolerance (IGT) who have established coronary heart disease (CHD) or acute coronary syndrome (ACS). A secondary objective of the study is to determine if acarbose therapy can prevent or delay transition to type 2 diabetes mellitus (T2DM) in this patient population.
Read the detailed description
A long-term, multicentre, double-blind, randomised parallel-group trial to determine whether reducing post-prandial glycaemia can reduce cardiovascular-related morbidity and mortality in patients with established coronary heart disease or acute coronary syndrome who have impaired glucose tolerance.
- Conditions
- Coronary Heart Disease, Acute Coronary Syndrome, Impaired Glucose Tolerance, Type 2 Diabetes Mellitus (T2DM)
- Being tested
- Acarbose, Matching Placebo
- Keywords
- Acarbose
- Medical subject headings
- Coronary Disease, Acute Coronary Syndrome, Glucose Intolerance, Diabetes Mellitus, Type 2
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AcarboseDrug
Also called Glucobay
The participants were given one tablet (50mg) of acarbose per day, taken with a meal during their first week (7 days). During the second week, the dose was increased to two tablets/day (50mg twice a day i.e. 100mg/day) and then three tablets/day (50mg three times a day i.e. 150mg/day) thereafter. The maximum tolerated dose is being taken for the duration of the trial (maximum dose is 150mg/day).
Matching PlaceboDrug
The participants were given one tablet of matching placebo per day, taken with a meal during their first week (7 days). During the second week, the dose was increased to two tablets/day and then three tablets/day thereafter. The maximum tolerated dose is being taken for the duration of the trial (maximum dose is 3 tablets/day).
| Study group | Role | What they receive |
|---|---|---|
| Acarbose | Active comparator | The participants were given one tablet (50mg) of acarbose per day, taken with a meal during their first week (7 days). During the second week, the dose was increased to two tablets/day (50mg twice a day i.e. 100mg/day) and then three tablets/day (50mg three times a day i.e. 150mg/day) thereafter. The maximum tolerated dose is being taken for the duration of the trial (maximum dose is 150mg/day). Receives: Drug: Acarbose |
| Matching Placebo | Placebo comparator | The participants were given one tablet of matching placebo per day, taken with a meal during their first week (7 days). During the second week, the dose was increased to two tablets/day and then three tablets/day thereafter. The maximum tolerated dose is being taken for the duration of the trial (maximum dose is 3 tablets/day). Receives: Drug: Matching Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
A composite cardiovascular outcome defined as the time after randomisation to the first occurrence of any one of the following: -Cardiovascular death -Non-fatal MI -Non-fatal stroke -Hospitalisation for Unstable Angina -Hospitalisation for Heart Failure
Measured: Follow-up until 728 adjudicated Primary Outcome Measures have been recorded
Secondary outcomes (6)
Transition to type 2 diabetes confirmed by two successive diagnostic plasma glucose values (FPG >7.0 mmol/l and/or 2HPG > 11.1 mmol/l), with no intervening non-diagnostic values.
All cause mortality
Each of the components of the primary composite cardiovascular outcome will also be analysed individually, both as first and as total events.
Major Cardiovascular Event (MACE) composite cardiovascular outcome, defined as the time after randomisation to the first occurrence of any one of the following: - Cardiovascular death - Non-fatal MI - Non-fatal stroke
Impaired renal function as evidenced by: A reduced estimate of glomerular filtration rate( eGFR <30 ml/minute/ 1.73 m2) estimated using the Chinese MDRD formula, a doubling of the baseline plasma creatinine level, a halving of the baseline eGFR
Resource use, costs and cost effectiveness
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jan 2009 (estimated)
- Study start17 Feb 2009
- Primary completion11 Apr 2017
- Study completion18 Apr 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Coronary Heart DiseaseStudies of the same condition, open and under way.
- More trials run by University of OxfordThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 6,526 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Oxford
- Sponsor type
- University, hospital or other
- Collaborators
- Bayer
- Responsible party
- Sponsor
- Investigators
- Professor Rury R Holman, FRCP FMedSci, Principal investigator, Diabetes Trials Unit, University of Oxford
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00829660
- Sponsor's protocol ID
- 11232
- Other IDs
- ISRCTN91899513
- Acronym
- ACE
- Status last verified
- Jul 2017
- First submitted
- 26 Jan 2009
- Last updated
- 25 Jul 2017
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- Undecided
Publications
Wamil M, McMurray JJV, Scott CAB, Coleman RL, Sun Y, Standl E, Ryden L, Holman RR. Predicting heart failure events in patients with coronary heart disease and impaired glucose tolerance: Insights from the Acarbose Cardiovascular Evaluation (ACE) trial. Diabetes Res Clin Pract. 2020 Dec;170:108488. doi: 10.1016/j.diabres.2020.108488. Epub 2020 Oct 6.
PubMed 33035598Gerstein HC, Coleman RL, Scott CAB, Xu S, Tuomilehto J, Ryden L, Holman RR; ACE Study Group. Impact of Acarbose on Incident Diabetes and Regression to Normoglycemia in People With Coronary Heart Disease and Impaired Glucose Tolerance: Insights From the ACE Trial. Diabetes Care. 2020 Sep;43(9):2242-2247. doi: 10.2337/dc19-2046. Epub 2020 Jul 8.
PubMed 32641379Holman RR, Coleman RL, Chan JCN, Chiasson JL, Feng H, Ge J, Gerstein HC, Gray R, Huo Y, Lang Z, McMurray JJ, Ryden L, Schroder S, Sun Y, Theodorakis MJ, Tendera M, Tucker L, Tuomilehto J, Wei Y, Yang W, Wang D, Hu D, Pan C; ACE Study Group. Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2017 Nov;5(11):877-886. doi: 10.1016/S2213-8587(17)30309-1. Epub 2017 Sep 13.
PubMed 28917545
Study at a glance
From the registry record, last updated by the sponsor on 25 Jul 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Long-term, Multicentre, Double-blind, Randomised Parallel-group Trial to Determine Whether Reducing Post-prandial Glycaemia Can Reduce Cardiovascular-related Morbidity and Mortality in Patients With Established Coronary Heart Disease or Acute Coronary Syndrome Who Have Impaired Glucose Tolerance
- ClinicalTrials.gov ID
- NCT00829660
- Acronym / sponsor ID
- ACE / 11232
- Conditions
- Coronary Heart Disease, Acute Coronary Syndrome, Impaired Glucose Tolerance, Type 2 Diabetes Mellitus (T2DM)
- Keywords
- Acarbose
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 6,526 participants (actual)
- Lead sponsor
- University of OxfordUniversity, hospital or other
- Collaborators
- Bayer
- Study start
- 17 Feb 2009 (actual)
- Primary completion
- 11 Apr 2017 (actual)
- Study completion
- 18 Apr 2017 (actual)
- First posted
- 27 Jan 2009 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine whether acarbose therapy can reduce cardiovascular-related morbidity and mortality in patients with impaired glucose tolerance (IGT) who have established coronary heart disease (CHD) or acute coronary syndrome (ACS). A secondary objective of the study is to determine if acarbose therapy can prevent or delay transition to type 2 diabetes mellitus (T2DM) in this patient population.
Detailed description
A long-term, multicentre, double-blind, randomised parallel-group trial to determine whether reducing post-prandial glycaemia can reduce cardiovascular-related morbidity and mortality in patients with established coronary heart disease or acute coronary syndrome who have impaired glucose tolerance.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Acarbose | Active comparator | Drug: AcarboseThe participants were given one tablet (50mg) of acarbose per day, taken with a meal during their first week (7 days). During the second week, the dose was increased to two tablets/day (50mg twice a day i.e. 100mg/day) and then three tablets/day (50mg three times a day i.e. 150mg/day) thereafter. The maximum tolerated dose is being taken for the duration of the trial (maximum dose is 150mg/day). |
| Matching Placebo | Placebo comparator | Drug: Matching PlaceboThe participants were given one tablet of matching placebo per day, taken with a meal during their first week (7 days). During the second week, the dose was increased to two tablets/day and then three tablets/day thereafter. The maximum tolerated dose is being taken for the duration of the trial (maximum dose is 3 tablets/day). |
Who may qualify
- Ages
- 50 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (17 listed)
- Male or female, aged 50 years or more.
- Definite CHD, defined as a, b or c below:
- Impaired glucose tolerance diagnosed on a single standard oral glucose tolerance test (OGTT) , defined as a 2-hour plasma glucose (2HPG) value ≥7.8 but <11.1 mmol/l and a fasting plasma glucose (FPG) <7.0 mmol/l within six months prior to enrollment.
- Optimised cardiovascular drug therapy.
- At least 80% adherent to single blind placebo Study Medication during the run-in period.
Key exclusion criteria (11 listed)
- Previous history of diabetes, other than gestational diabetes.
- MI, unstable angina, stroke or a transient ischaemic attack (TIA) within the previous three months.
- Planned or anticipated coronary, cerebrovascular or peripheral arterial revascularisation or other major surgical intervention, at the time of randomisation
- New York Heart Association (NYHA) class III or IV heart failure.
- Evidence of severe hepatic disease.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AcarboseAlso: GlucobayThe participants were given one tablet (50mg) of acarbose per day, taken with a meal during their first week (7 days). During the second week, the dose was increased to two tablets/day (50mg twice a day i.e. 100mg/day) and then three tablets/day (50mg three times a day i.e. 150mg/day) thereafter. The maximum tolerated dose is being taken for the duration of the trial (maximum dose is 150mg/day). | Drug | Acarbose |
| Matching PlaceboThe participants were given one tablet of matching placebo per day, taken with a meal during their first week (7 days). During the second week, the dose was increased to two tablets/day and then three tablets/day thereafter. The maximum tolerated dose is being taken for the duration of the trial (maximum dose is 3 tablets/day). | Drug | Matching Placebo |
Primary outcome
A composite cardiovascular outcome defined as the time after randomisation to the first occurrence of any one of the following: -Cardiovascular death -Non-fatal MI -Non-fatal stroke -Hospitalisation for Unstable Angina -Hospitalisation for Heart Failure
Time frame: Follow-up until 728 adjudicated Primary Outcome Measures have been recorded
6 secondary outcomes
Transition to type 2 diabetes confirmed by two successive diagnostic plasma glucose values (FPG >7.0 mmol/l and/or 2HPG > 11.1 mmol/l), with no intervening non-diagnostic values.
All cause mortality
Each of the components of the primary composite cardiovascular outcome will also be analysed individually, both as first and as total events.
Major Cardiovascular Event (MACE) composite cardiovascular outcome, defined as the time after randomisation to the first occurrence of any one of the following: - Cardiovascular death - Non-fatal MI - Non-fatal stroke
Impaired renal function as evidenced by: A reduced estimate of glomerular filtration rate( eGFR <30 ml/minute/ 1.73 m2) estimated using the Chinese MDRD formula, a doubling of the baseline plasma creatinine level, a halving of the baseline eGFR
Resource use, costs and cost effectiveness
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Jul 2017.
- Derived from this study: PubMed 33035598Wamil M, McMurray JJV, Scott CAB, Coleman RL, Sun Y, Standl E, Ryden L, Holman RR. Predicting heart failure events in patients with coronary heart disease and impaired glucose tolerance: Insights from the Acarbose Cardiovascular Evaluation (ACE) trial. Diabetes Res Clin Pract. 2020 Dec;170:108488. doi: 10.1016/j.diabres.2020.108488. Epub 2020 Oct 6.
- Derived from this study: PubMed 32641379Gerstein HC, Coleman RL, Scott CAB, Xu S, Tuomilehto J, Ryden L, Holman RR; ACE Study Group. Impact of Acarbose on Incident Diabetes and Regression to Normoglycemia in People With Coronary Heart Disease and Impaired Glucose Tolerance: Insights From the ACE Trial. Diabetes Care. 2020 Sep;43(9):2242-2247. doi: 10.2337/dc19-2046. Epub 2020 Jul 8.
- Derived from this study: PubMed 28917545Holman RR, Coleman RL, Chan JCN, Chiasson JL, Feng H, Ge J, Gerstein HC, Gray R, Huo Y, Lang Z, McMurray JJ, Ryden L, Schroder S, Sun Y, Theodorakis MJ, Tendera M, Tucker L, Tuomilehto J, Wei Y, Yang W, Wang D, Hu D, Pan C; ACE Study Group. Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2017 Nov;5(11):877-886. doi: 10.1016/S2213-8587(17)30309-1. Epub 2017 Sep 13.
- Diabetes Trials Unit, International Co-ordinating Centre for the ACE TrialLink provided by the sponsor.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Professor Rury R Holman, FRCP FMedSci principal investigator
Diabetes Trials Unit, University of Oxford
177 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Acarbose in people with Coronary Heart Disease and Acute Coronary Syndrome, run by University of Oxford at 177 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 17 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 25 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 177 sites in China, Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
A composite cardiovascular outcome defined as the time after randomisation to the first occurrence of any one of the following: -Cardiovascular death -Non-fatal MI -Non-fatal stroke -Hospitalisation for Unstable Angina -Hospitalisation for Heart Failure (time frame: Follow-up until 728 adjudicated Primary Outcome Measures have been recorded). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00829660, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Jul 2017.