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Diabetes Care:长期强化血糖控制能否降低糖尿病患者的心血管疾病风险?

2016-05-23 MedSci MedSci原创

在控制糖尿病患者心血管风险行为(ACCORD)试验中,2型糖尿病和其他心血管危险因素的参与者进行约4年的强化 vs 标准血糖控后对复合心血管预后具有中性作用,增加了心血管和总死亡率,并减少非致死性心肌梗死。强化的结果在延长的随访期间进行了分析。所有幸存的ACCORD参与者都被应邀参加ACCORD后续(ACCORDION)的研究,在此期间,研究人员根据参与者的医疗保健提供者的判断进行治疗。心血管疾病

在控制糖尿病患者心血管风险行为(ACCORD)试验中,2型糖尿病和其他心血管危险因素的参与者进行约4年的强化 vs 标准血糖控后对复合心血管预后具有中性作用,增加了心血管和总死亡率,并减少非致死性心肌梗死。强化的结果在延长的随访期间进行了分析。


所有幸存的ACCORD参与者都被应邀参加ACCORD后续(ACCORDION)的研究,在此期间,研究人员根据参与者的医疗保健提供者的判断进行治疗。心血管疾病和其他健康有关的成果被前瞻性地收集,并根据对参与者最初分配组使用意向性治疗方法进行分析。

共有8601名参与者,在ACCORDION研究期间,98%的参与者没有遭受主要结局或死亡,平均监测8.8年,随机分组后平均7.7年。平均3.7年的强化血糖降低对主要复合终点(非致死性心肌梗死,非致死性卒中或心血管死亡),全因死亡和包括全因死亡的扩大的复合终点有中性的长期影响。此外,心血管疾病死亡的危险性在活跃期(风险比1.49;95%CI 1.19,1.87;P<0.0001)降低(HR 1.20;95%CI 1.03,1.39;P=0.02)。

在高危2型糖尿病人群中监测9年,平均3.7年的强化血糖控制对死亡和非致死性心血管事件有中性影响,但增加了心血管疾病有关的死亡。

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    2016-05-24 午夜星河

    强化降糖

    0

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