Effect of Valsartan on the Incidence of Diabetes and
Cardiovascular Events

J 2010

Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events

MCMURRAY, John; Rury R. HOLMAN; Steven M. HAFFNER; M. A. BETHEL; B. HOLZHAUER et al.

Základní údaje

Originální název

Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events

Autoři

MCMURRAY, John; Rury R. HOLMAN; Steven M. HAFFNER; M. A. BETHEL; B. HOLZHAUER; T. A. HUA; Y. BELENKOV; M. BOOLELL; J. B. BUSE; B. M. BUCKLEY; A. R. CHACRA; F. T. CHIANG; B. CHARBONNEL; C. C. CHOW; M. J. DAVIES; P. DEEDWANIA; P. DIEM; D. EINHORN; V. FONSECA; G. R. FULCHER; Z. GACIONG; S. GAZTAMBIDE; T. GILES; E. HORTON; H. ILKOVA; T. JENSSEN; S. E. KAHN; H. KRUM; M. LAAKSO; L. A. LEITER; N.S. LEVITT; V. MAREEV; F. MARTINEZ; C. MASSON; T. MAZZONE; E. MEANEY; R. NESTO; C. Y. PAN; R. PRAGER; S. A. RAPTIS; G. RUTTEN; H. SANDSTROEM; F. SCHAPER; A. SCHEEN; O. SCHMITZ; I. SINAY; Vladimír SOŠKA; S. STENDER; G. TAMAS; G. TOGNONI; J. TUOMILEHTO; A. S. VILLAMIL; J. VOZAR a R. M. CALIFF

Vydání

New England Journal of Medicine, USA, MASSACHUSETTS MEDICAL SOC, 2010, 0028-4793

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 53.486

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/10:00051692

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1056/NEJMoa1001121

UT WoS

000276894700007

Klíčová slova anglicky

IMPAIRED GLUCOSE-TOLERANCE; CONVERTING-ENZYME-INHIBITORS; RANDOMIZED CONTROLLED-TRIAL; LIFE-STYLE INTERVENTIONS; CORONARY-ARTERY-DISEASE; HIGH-RISK PATIENTS; FASTING GLUCOSE; METABOLIC SYNDROME; CLINICAL-TRIALS; HEART-FAILURE

Příznaky

Mezinárodní význam

Změněno: 18. 4. 2012 10:03, Mgr. Michal Petr

Anotace

V originále

It is not known whether drugs that block the renin-angiotensin system reduce the risk of diabetes and cardiovascular events in patients with impaired glucose tolerance. METHODS In this double-blind, randomized clinical trial with a 2-by-2 factorial design, we assigned 9306 patients with impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors to receive valsartan (up to 160 mg daily) or placebo (and nateglinide or placebo) in addition to lifestyle modification. We then followed the patients for a median of 5.0 years for the development of diabetes (6.5 years for vital status). We studied the effects of valsartan on the occurrence of three coprimary outcomes: the development of diabetes; an extended composite outcome of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, arterial revascularization, or hospitalization for unstable angina; and a core composite outcome that excluded unstable angina and revascularization. RESULTS The cumulative incidence of diabetes was 33.1% in the valsartan group, as compared with 36.8% in the placebo group (hazard ratio in the valsartan group, 0.86; 95% confidence interval [CI], 0.80 to 0.92; P<0.001). Valsartan, as compared with placebo, did not significantly reduce the incidence of either the extended cardiovascular outcome (14.5% vs. 14.8%; hazard ratio, 0.96; 95% CI, 0.86 to 1.07; P = 0.43) or the core cardiovascular outcome (8.1% vs. 8.1%; hazard ratio, 0.99; 95% CI, 0.86 to 1.14; P = 0.85). CONCLUSIONS Among patients with impaired glucose tolerance and cardiovascular disease or risk factors, the use of valsartan for 5 years, along with lifestyle modification, led to a relative reduction of 14% in the incidence of diabetes but did not reduce the rate of cardiovascular events.

Citovat

@article{919407,
   author = {McMurray, John and Holman, Rury R. and Haffner, Steven M. and Bethel, M. A. and Holzhauer, B. and Hua, T. A. and Belenkov, Y. and Boolell, M. and Buse, J. B. and Buckley, B. M. and Chacra, A. R. and Chiang, F. T. and Charbonnel, B. and Chow, C. C. and Davies, M. J. and Deedwania, P. and Diem, P. and Einhorn, D. and Fonseca, V. and Fulcher, G. R. and Gaciong, Z. and Gaztambide, S. and Giles, T. and Horton, E. and Ilkova, H. and Jenssen, T. and Kahn, S. E. and Krum, H. and Laakso, M. and Leiter, L. A. and Levitt, N.S. and Mareev, V. and Martinez, F. and Masson, C. and Mazzone, T. and Meaney, E. and Nesto, R. and Pan, C. Y. and Prager, R. and Raptis, S. A. and Rutten, G. and Sandstroem, H. and Schaper, F. and Scheen, A. and Schmitz, O. and Sinay, I. and Soška, Vladimír and Stender, S. and Tamas, G. and Tognoni, G. and Tuomilehto, J. and Villamil, A. S. and Vozar, J. and Califf, R. M.},
   article_location = {USA},
   article_number = {16},
   doi = {https://doi.org/10.1056/NEJMoa1001121},
   keywords = {IMPAIRED GLUCOSE-TOLERANCE; CONVERTING-ENZYME-INHIBITORS; RANDOMIZED CONTROLLED-TRIAL; LIFE-STYLE INTERVENTIONS; CORONARY-ARTERY-DISEASE; HIGH-RISK PATIENTS; FASTING GLUCOSE; METABOLIC SYNDROME; CLINICAL-TRIALS; HEART-FAILURE},
   language = {eng},
   issn = {0028-4793},
   journal = {New England Journal of Medicine},
   title = {Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events},
   volume = {362},
   year = {2010}
}

TY  - JOUR
ID  - 919407
AU  - McMurray, John - Holman, Rury R. - Haffner, Steven M. - Bethel, M. A. - Holzhauer, B. - Hua, T. A. - Belenkov, Y. - Boolell, M. - Buse, J. B. - Buckley, B. M. - Chacra, A. R. - Chiang, F. T. - Charbonnel, B. - Chow, C. C. - Davies, M. J. - Deedwania, P. - Diem, P. - Einhorn, D. - Fonseca, V. - Fulcher, G. R. - Gaciong, Z. - Gaztambide, S. - Giles, T. - Horton, E. - Ilkova, H. - Jenssen, T. - Kahn, S. E. - Krum, H. - Laakso, M. - Leiter, L. A. - Levitt, N.S. - Mareev, V. - Martinez, F. - Masson, C. - Mazzone, T. - Meaney, E. - Nesto, R. - Pan, C. Y. - Prager, R. - Raptis, S. A. - Rutten, G. - Sandstroem, H. - Schaper, F. - Scheen, A. - Schmitz, O. - Sinay, I. - Soška, Vladimír - Stender, S. - Tamas, G. - Tognoni, G. - Tuomilehto, J. - Villamil, A. S. - Vozar, J. - Califf, R. M.
PY  - 2010
TI  - Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events
JF  - New England Journal of Medicine
VL  - 362
IS  - 16
SP  - 1477-1490
EP  - 1477-1490
PB  - MASSACHUSETTS MEDICAL SOC
SN  - 00284793
KW  - IMPAIRED GLUCOSE-TOLERANCE
KW  - CONVERTING-ENZYME-INHIBITORS
KW  - RANDOMIZED CONTROLLED-TRIAL
KW  - LIFE-STYLE INTERVENTIONS
KW  - CORONARY-ARTERY-DISEASE
KW  - HIGH-RISK PATIENTS
KW  - FASTING GLUCOSE
KW  - METABOLIC SYNDROME
KW  - CLINICAL-TRIALS
KW  - HEART-FAILURE
N2  - It is not known whether drugs that block the renin-angiotensin system reduce the risk of diabetes and cardiovascular events in patients with impaired glucose tolerance. METHODS In this double-blind, randomized clinical trial with a 2-by-2 factorial design, we assigned 9306 patients with impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors to receive valsartan (up to 160 mg daily) or placebo (and nateglinide or placebo) in addition to lifestyle modification. We then followed the patients for a median of 5.0 years for the development of diabetes (6.5 years for vital status). We studied the effects of valsartan on the occurrence of three coprimary outcomes: the development of diabetes; an extended composite outcome of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, arterial revascularization, or hospitalization for unstable angina; and a core composite outcome that excluded unstable angina and revascularization. RESULTS The cumulative incidence of diabetes was 33.1% in the valsartan group, as compared with 36.8% in the placebo group (hazard ratio in the valsartan group, 0.86; 95% confidence interval [CI], 0.80 to 0.92; P<0.001). Valsartan, as compared with placebo, did not significantly reduce the incidence of either the extended cardiovascular outcome (14.5% vs. 14.8%; hazard ratio, 0.96; 95% CI, 0.86 to 1.07; P = 0.43) or the core cardiovascular outcome (8.1% vs. 8.1%; hazard ratio, 0.99; 95% CI, 0.86 to 1.14; P = 0.85). CONCLUSIONS Among patients with impaired glucose tolerance and cardiovascular disease or risk factors, the use of valsartan for 5 years, along with lifestyle modification, led to a relative reduction of 14% in the incidence of diabetes but did not reduce the rate of cardiovascular events.
ER  -

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