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 and R. M. CALIFF. Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events. New England Journal of Medicine. USA: MASSACHUSETTS MEDICAL SOC, 2010, vol. 362, No 16, p. 1477-1490. ISSN 0028-4793. Available from: https://dx.doi.org/10.1056/NEJMoa1001121.
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Basic information
Original name Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events
Authors MCMURRAY, John (826 United Kingdom of Great Britain and Northern Ireland, guarantor), Rury R. HOLMAN (826 United Kingdom of Great Britain and Northern Ireland), Steven M. HAFFNER (826 United Kingdom of Great Britain and Northern Ireland), M. A. BETHEL (826 United Kingdom of Great Britain and Northern Ireland), B. HOLZHAUER (756 Switzerland), T. A. HUA (840 United States of America), Y. BELENKOV (643 Russian Federation), M. BOOLELL (756 Switzerland), J. B. BUSE (840 United States of America), B. M. BUCKLEY (372 Ireland), A. R. CHACRA (76 Brazil), F. T. CHIANG (158 Taiwan), B. CHARBONNEL (250 France), C. C. CHOW (156 China), M. J. DAVIES (826 United Kingdom of Great Britain and Northern Ireland), P. DEEDWANIA (840 United States of America), P. DIEM (756 Switzerland), D. EINHORN (840 United States of America), V. FONSECA (840 United States of America), G. R. FULCHER (36 Australia), Z. GACIONG (616 Poland), S. GAZTAMBIDE (724 Spain), T. GILES (840 United States of America), E. HORTON (840 United States of America), H. ILKOVA (76 Brazil), T. JENSSEN (578 Norway), S. E. KAHN (840 United States of America), H. KRUM (36 Australia), M. LAAKSO (246 Finland), L. A. LEITER (124 Canada), N.S. LEVITT (710 South Africa), V. MAREEV (643 Russian Federation), F. MARTINEZ (724 Spain), C. MASSON (756 Switzerland), T. MAZZONE (840 United States of America), E. MEANEY (484 Mexico), R. NESTO (840 United States of America), C. Y. PAN (156 China), R. PRAGER (40 Austria), S. A. RAPTIS (300 Greece), G. RUTTEN (528 Netherlands), H. SANDSTROEM (752 Sweden), F. SCHAPER (276 Germany), A. SCHEEN (56 Belgium), O. SCHMITZ (208 Denmark), I. SINAY (32 Argentina), Vladimír SOŠKA (203 Czech Republic, belonging to the institution), S. STENDER (208 Denmark), G. TAMAS (348 Hungary), G. TOGNONI (380 Italy), J. TUOMILEHTO (246 Finland), A. S. VILLAMIL (32 Argentina), J. VOZAR (703 Slovakia) and R. M. CALIFF (840 United States of America).
Edition New England Journal of Medicine, USA, MASSACHUSETTS MEDICAL SOC, 2010, 0028-4793.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 53.486
RIV identification code RIV/00216224:14110/10:00051692
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1056/NEJMoa1001121
UT WoS 000276894700007
Keywords in English 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
Tags International impact
Changed by Changed by: Mgr. Michal Petr, učo 65024. Changed: 18/4/2012 10:03.
Abstract
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.
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