Intensive lowering of systolic blood pressure to a target of less than 120 mm Hg has no effect on the rate of fatal and non-fatal major cardiovascular events in high-risk patients with type 2 diabetes

2010 ◽  
Vol 15 (5) ◽  
pp. 142-143
Author(s):  
A. Chugh ◽  
G. Bakris
Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2-OR
Author(s):  
MARCUS V.B. MALACHIAS ◽  
PARDEEP JHUND ◽  
BRIAN CLAGGETT ◽  
MAGNUS O. WIJKMAN ◽  
RHONDA BENTLEY-LEWIS ◽  
...  

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Marcus V. B. Malachias ◽  
Pardeep S. Jhund ◽  
Brian L. Claggett ◽  
Magnus O. Wijkman ◽  
Rhonda Bentley‐Lewis ◽  
...  

Background NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) improves the discriminatory ability of risk‐prediction models in type 2 diabetes mellitus (T2DM) but is not yet used in clinical practice. We assessed the discriminatory strength of NT‐proBNP by itself for death and cardiovascular events in high‐risk patients with T2DM. Methods and Results Cox proportional hazards were used to create a base model formed by 20 variables. The discriminatory ability of the base model was compared with that of NT‐proBNP alone and with NT‐proBNP added, using C‐statistics. We studied 5509 patients (with complete data) of 8561 patients with T2DM and cardiovascular and/or chronic kidney disease who were enrolled in the ALTITUDE (Aliskiren in Type 2 Diabetes Using Cardiorenal Endpoints) trial. During a median 2.6‐year follow‐up period, 469 patients died and 768 had a cardiovascular composite outcome (cardiovascular death, resuscitated cardiac arrest, nonfatal myocardial infarction, stroke, or heart failure hospitalization). NT‐proBNP alone was as discriminatory as the base model for predicting death (C‐statistic, 0.745 versus 0.744, P =0.95) and the cardiovascular composite outcome (C‐statistic, 0.723 versus 0.731, P =0.37). When NT‐proBNP was added, it increased the predictive ability of the base model for death (C‐statistic, 0.779 versus 0.744, P <0.001) and for cardiovascular composite outcome (C‐statistic, 0.763 versus 0.731, P <0.001). Conclusions In high‐risk patients with T2DM, NT‐proBNP by itself demonstrated discriminatory ability similar to a multivariable model in predicting both death and cardiovascular events and should be considered for risk stratification. Registration URL: https://www.clini​caltr​ials.gov ; Unique identifier: NCT00549757.


2016 ◽  
Author(s):  
Raul M. Luque ◽  
Manuel D. Gahete ◽  
Mercedes del Rio-Moreno ◽  
Sergio Pedraza-Arevalo ◽  
Antonio Camargo ◽  
...  

Drug Safety ◽  
2009 ◽  
Vol 32 (3) ◽  
pp. 187-202 ◽  
Author(s):  
John Dormandy ◽  
Mondira Bhattacharya ◽  
Anne-Ruth van Troostenburg de Bruyn

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Rosalia Dettori ◽  
Andrea Milzi ◽  
Kathrin Burgmaier ◽  
Mohammad Almalla ◽  
Martin Hellmich ◽  
...  

Abstract Background Type 2 diabetes mellitus (T2DM) is associated with an increased cardiovascular risk related at least in part to a more vulnerable plaque phenotype. However, patients with T2DM exhibit also an increased risk following percutaneous coronary intervention (PCI). It is unknown if plaque vulnerability of a treated lesion influences cardiovascular outcomes in patients with T2DM. In this study, we aimed to assess the association of plaque morphology as determined by optical coherence tomography (OCT) with cardiovascular outcome following PCI in high-risk patients with T2DM. Methods 81 patients with T2DM and OCT-guided PCI were recruited. Pre-interventional OCT and systematic follow-up of median 66.0 (IQR = 8.0) months were performed. Results During follow-up, 24 patients (29.6%) died. The clinical parameters age (HR 1.16 per year, 95% CI 1.07–1.26, p < 0.001), diabetic polyneuropathy (HR 3.58, 95% CI 1.44–8.93, p = 0.006) and insulin therapy (HR 3.25, 95% CI 1.21–8.70, p = 0.019) predicted mortality in T2DM patients independently. Among OCT parameters only calcium-volume-index (HR 1.71 per 1000°*mm, 95% CI 1.21–2.41, p = 0.002) and lesion length (HR 1.93 per 10 mm, 95% CI 1.02–3.67, p = 0.044) as parameters describing atherosclerosis extent were significant independent predictors of mortality. However, classical features of plaque vulnerability, such as thickness of the fibrous cap, the extent of the necrotic lipid core and the presence of macrophages had no significant predictive value (all p = ns). Conclusion Clinical parameters including those describing diabetes severity as well as OCT-parameters characterizing atherosclerotic extent but not classical features of plaque vulnerability predict mortality in T2DM patients following PCI. These data suggest that PCI may provide effective plaque sealing resulting in limited importance of local target lesion vulnerability for future cardiovascular events in high-risk patients with T2DM.


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