دورية أكاديمية
Increased risk of severe hypoglycemic events before and after cardiovascular outcomes in TECOSSuggests an at-risk type 2 diabetes frail patient phenotype
| العنوان: | Increased risk of severe hypoglycemic events before and after cardiovascular outcomes in TECOSSuggests an at-risk type 2 diabetes frail patient phenotype |
|---|---|
| المؤلفون: | Standl, E., Stevens, S. R., Armstrong, P. W., Buse, J. B., Chan, J. C. N., Green, J. B., Lachin, J. M., Scheen, André, Travert, F., Van De Werf, F., Peterson, E. D., Holman, R. R. |
| المصدر: | Diabetes Care, 41 (3), 596-603 (2018) |
| بيانات النشر: | American Diabetes Association Inc. |
| سنة النشر: | 2018 |
| المجموعة: | University of Liège: ORBi (Open Repository and Bibliography) |
| مصطلحات موضوعية: | Article, Aged, Body Weight, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Double-Blind Method, Endpoint Determination, Female, Glomerular Filtration Rate, Hospitalization, Humans, Hypoglycemia, Incidence, Insulin, Male, Proportional Hazards Models, Risk Factors, Sitagliptin Phosphate, Treatment Outcome, Human health sciences, Cardiovascular & respiratory systems, Endocrinology, metabolism & nutrition, Sciences de la santé humaine, Systèmes cardiovasculaire & respiratoire, Endocrinologie, métabolisme & nutrition |
| الوصف: | peer reviewed ; OBJECTIVE Severe hypoglycemic events (SHEs) in type 2 diabetes are associated with subsequent cardiovascular (CV) event risk.We examined whether CV events were associated with subsequent SHE risk. RESEARCH DESIGN AND METHODS Time-dependent associations between SHEs and a composite CV end point (fatal/ nonfatal myocardial infarction or stroke, hospitalization for unstable angina, hospitalization for heart failure [hHF]) were examined post hoc in 14,671 TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin) participants with type 2 diabetes and CV disease followed for a median of 3.0 years. RESULTS SHEs were uncommon and unassociated with sitagliptin therapy (N = 160 [2.2%], 0.78/100 patient-years vs. N = 143 [1.9%], 0.70/100 patient-years for placebo; hazard ratio [HR] 1.12 [95%CI 0.89, 1.40], P = 0.33). Patientswith (versus without) SHEswere older with longer diabetes duration, lower body weight, and lower estimated glomerular filtration rate;weremore frequentlywomen, nonwhite, and insulin treated; and more often had microalbuminuria or macroalbuminuria. Analyses adjusted for clinical factors showed SHEs were associated with increased risk of the primary composite CV end point (1.55 [1.06, 2.28], P = 0.025), all-cause death (1.83 [1.22, 2.75], P = 0.004), and CV death (1.72 [1.02, 2.87], P = 0.040). Conversely, nonfatal myocardial infarction (3.02 [1.83, 4.96], P < 0.001), nonfatal stroke (2.77 [1.36, 5.63], P = 0.005), and hHF (3.68 [2.13, 6.36], P < 0.001) were associated with increased risk of SHEs. Fully adjusted models showed no association between SHEs and subsequent CV or hHF events, but the association between CV events and subsequent SHEs remained robust. CONCLUSIONS These findings, showing greater risk of SHEs after CV events and greater risk of CV events after SHEs, suggest a common at-risk type 2 diabetes frail patient phenotype. © 2017 by The American Diabetes Association. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0149-5992 1935-5548 |
| العلاقة: | urn:issn:0149-5992; urn:issn:1935-5548; https://orbi.uliege.be/handle/2268/235339Test; info:hdl:2268/235339; scopus-id:2-s2.0-85042599018; info:pmid:29311155 |
| DOI: | 10.2337/dc17-1778 |
| الإتاحة: | https://doi.org/10.2337/dc17-1778Test https://orbi.uliege.be/handle/2268/235339Test |
| حقوق: | restricted access ; http://purl.org/coar/access_right/c_16ecTest ; info:eu-repo/semantics/restrictedAccess |
| رقم الانضمام: | edsbas.CD8CA850 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 01495992 19355548 |
|---|---|
| DOI: | 10.2337/dc17-1778 |