Acarbose Cardiovascular Evaluation Trial (ACE)
Coronary Heart Disease, Acute Coronary Syndrome, Impaired Glucose Tolerance
About this trial
This is an interventional prevention trial for Coronary Heart Disease focused on measuring Acarbose
Eligibility Criteria
Inclusion Criteria:
- 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
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.
Exclusion Criteria:
- 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)
- 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.
Sites / Locations
- The First Affiliated Hospital of Anhui Medical University
- Beijing Chuiyangliu Hospital
- China Meitan General Hospital
- Beijing Anzhen Hospital of The Capital University of Medical Sciences
- China-Japan Friendship Hospital
- Peking University First Hospital
- Beijing Ji Shui Tan Hospital
- Beijing Shijitan Hospital
- Fu Xing Hospital
- Beijing Shijingshan Hospital
- Peking University People's Hospital
- Aerospace Central Hospital
- Affiliated to The Capital University of Medical Sciences Beijing Friendship Hospital
- Wangjing Hospital of CACMS
- Xuanwu Hospital Capital Medical University
- Beijing Healthy Palace Hospital
- Aerospace 731 Hospital
- General Hospital of Second Artillery PLA
- Peking Union Medical College Hospital
- PLA General Hospital
- Anzhen Hospital of The Capital University of Medical Sciences 2nd.
- Beijing Pinggu Hospital
- Beijing Yanhua Hospital
- Chongqing Medical University Second Afflicated Hospital
- Chongqing Zhongshan Hospital
- Chongqing Third People's Hospital
- The First Affiliated Hospital of Chongqing Medical University
- Da Ping Hospital
- The Second People's Hospital of Chongqing
- Fujian Provincial Hospital
- Union Hospital Affiliated to Fujian Medical University
- The People's Hospital of Fujian Province
- The First Hospital of Xiamen
- Zhongshan Hospital Xiamen University
- Guangdong General Hospital
- The First Affiliated Hospital of Guangdong Pharmaceutical University
- The First Affiliated Hospital of Sun Yat-Sen University
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
- The Third Affiliated Hospital of Guangzhou Medical College
- Wu Jing Zhong Dui Hospital of Guangdong Province
- The First Affiliated Hospital of Jinan University
- Peking University Shenzhen Hospital
- Zhong Shan City People's Hospital
- The Fifth Affiliated Hospital of Sun Yat-Sen University
- Liuzhou Worker's Hospital
- Liuzhou People's Hospital
- Minzu Hospital of Guangxi Zhuang Autonomous Region
- 303 Hospital of People's Liberation Army
- The First Affiliated Hospital of Guangxi Medical University
- The Affiliated Hospital of Guiyang Medical College
- Cangzhou Central Hospital
- The Second Hospital of Hebei Medical University
- The First Hospital of Hebei Medical University
- Bethune International Peace Hospital
- Tangshan Workers Hospital
- The Affiliated Hospital of North China Coal Medical University
- Yu Tian County Hospital
- The Third Affiliated Hospital of Hebei North University
- Da Qing Oilfield General Hospital
- The Fourth Affiliated Hospital of Harbin Medical University
- The First Affiliated Hospital of Henan Science & Technology University
- Luo Yang Central Hospital, Affiliated to Zhengzhou University
- The First Affiliated Hospital of Henan College of TCM
- The People's Hospital of Zhengzhou
- The Second Affiliated Hospital of Zhengzhou University
- Union Hospital of Tongji Medical College of Huazhong
- Wuhan Asia Heart Hospital
- Tongji Hospital of Tongji Medical College of Huazhong
- Pu'ai Hospital of Wuhan City
- Renmin Hospital of Wuhan University
- Zhongnan Hospital of Wuhan University
- Hunan Provincial People's Hospital
- The Fourth Hospital of Changsha
- Xiangya Hospital Central-South University
- The Third Hospital of Changsha
- The First Affiliated Hospital of Baotou Medical College
- Baotou Central Hospital
- Chifeng Municipal Hospital
- Inner Mongolia Hospital
- 81st Hospital of Chinese PLA
- Nanjing First Hospital
- Nanjing Drum Tower Hospital
- Nanjing Zhongda Hospital
- BENQ Hospital
- Jiangsu Province Official Hospital
- Jiangsu Province Hospital
- Jiangsu Provincial Hospital of TCM
- Nanjing Jiangning Hospital
- Suzhou Municipal Hospital
- Wuxi No.2 People's Hospital
- Wuxi People's Hospital
- Wuxi No.3 People's Hospital
- Hospital Affiliated Xuzhou Medical University
- The Second Affiliated Hospital of Xuzhou Medical University
- Zhenjiang First People's Hospital
- Jiujiang University Hospital
- Jiangxi Provincial People's Hospital
- The Second Affiliated Hospital of Nanchang University
- The Third Affiliated Hospital of Nanchang University
- China-Japan Union Hospital of Jilin University
- The Second Hospital of Jilin University
- The Central Hospital of Anshan
- Affiliated Zhongshan Hospital of Dalian University
- The First Hospital of Dalian Medical University
- Dalian Central Hospital
- Xianyang Central Hospital
- Shengjing Hospital of China Medical University
- The People's Hospital of Liaoning Province
- Shengjing Hospital of China Medical University
- The Fourth Hospital of China Medical University
- The First Hospital of Yinchuan
- Affiliated Hospital of Ningxia Medical University
- The People's Hospital of Ningxia Hui Autonomous Region
- Xi'an Central Hospital
- The First Affiliated Hospital of Xi'an Jiaotong University
- Affiliated Hospital of Xi'an Medical college
- Affiliated Hospital of Yan'an University
- Yan'an People's Hospital
- The First Hospital of Yulin
- The Central Hospital of Jinan
- The First People's Hospital of Jinan
- The General Hospital of Jinan Military Region
- Linyi People's Hospital
- Hospital Affiliated of Medical School, Qingdao University
- The Qingdao Municiple Hospital
- Qingdao Fuwai Hospital
- Taian City Central Hospital
- Shanghai Ninth People's Hospital
- Ruijin Hospital Affiliated to the Shanghai Jiaotong University Medical School
- Shanghai Central Hospital of Xuhui District
- Shanghai Zhongshan Hospital
- Shanghai Huadong Hospital
- Shanghai Putuo District People's Hospital
- Putuo District Center Hospital
- Tongji Hospital of Tongji University
- Shanghai Tenth People's Hospital
- Number 411 Hospital of PLA
- Shanghai Central Hospital of Yangpu District
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine
- Shanghai East Hospital
- Renji Hospital Affilicated to Jiaotong University School of Medicine
- Shanghai Pudong New Area Gongli Hospital
- Changhai Hospital
- Shanghai Zhabei District Shibei Hospital
- Shanghai Jinshan Hospital
- Shanghai Pudong New District People's Hospital
- General Hospital of Tisco
- The Third Engineering Bureau Hospital of Ministry of Railway
- Taiyuan City Central Hospital
- Shanxi Cardiovascular Hospital
- PLA No.323 Hospital
- Chengdu First People's Hospital
- Chengdu Second People's Hospital
- Sichuan Provincial People's Hospital
- The West China Hospital
- Sichuan Mianyang 404 Hospital
- Tianjin Union Hospital
- Tianjin Chest Hospital
- Tianjin Union Medicine Centre
- Army Police's Medical College Affiliated Hospital
- Tianjin Third Central Hospital
- Tianjin First Center Hospital
- The Second Hospital of Tianjin Medical University
- Dagang Oil-Field General Hospital
- The Fifth Central Hospital of Tianjin
- First Affiliated Hospital of the Medical College
- Xin Jiang Traditional Chinese Medicine Hospital
- General Hospital of Xinjiang Production and Construction Corps
- The 474th Hospital of PLA
- The First Teaching Hospital of Xinjiang Medical University
- The First Affiliated Hospital of Kunming Medical College
- The First People's Hospital of Yunnan Province
- The Second Affiliated Hospital of Kunming Medical College
- People's Hospital of Yuxi City
- Zhe Jiang Hospital
- Sir Run Run Shaw Hospital Affiliated With School of Medicine, Zhe Jiang University
- Prince of Wales Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Placebo Comparator
Acarbose
Matching Placebo
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).
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).