| Title: |
Cardiovascular Outcomes in GRADE (Glycemia Reduction Approaches in Type 2 Diabetes: A Comparative Effectiveness Study) |
| Authors: |
Green, Jennifer B; Everett, Brendan M; Ghosh, Alokananda; Younes, Naji; Krause-Steinrauf, Heidi; Barzilay, Joshua; Desouza, Cyrus; Inzucchi, Silvio E; Pokharel, Yashashwi; Schade, David; Scrymgeour, Alexandra; Tan, Meng H; Utzschneider, Kristina M; Mudaliar, Sunder; Crandall, JP; McKee, MD; Behringer-Massera, S; Brown-Friday, J; Xhori, E; Ballentine-Cargill, K; Duran, S; Estrella, H; Gonzalez de la Torre, S; Lukin, J; Phillips, LS; Burgess, E; Olson, D; Rhee, M; Wilson, P; Raines, TS; Boers, J; Costello, J; Maher-Albertelli, M; Mungara, R; Savoye, L; White, CA; Gullett, C; Holloway, L; Morehead, F; Person, S; Sibymon, M; Tanukonda, S; Adams, C; Ross, A; Balasubramanyam, A; Gaba, R; Gonzalez Hattery, E; Ideozu, A; Jimenez, J; Montes, G; Wright, C; Hollander, P; Roe, E; Jackson, A; Smiley, A; Burt, P; Estrada, L; Chionh, K; Ismail-Beigi, F; Falck-Ytter, C; Sayyed Kassem, L; Sood, A; Tiktin, M; Kulow, T; Newman, C; Stancil, KA; Cramer, B; Iacoboni, J; Kononets, MV; Sanders, C; Tucker, L; Werner, A; Maxwell, A; McPhee, G; Patel, C; Colosimo, L; Krol, A; Goland, R; Pring, J; Alfano, L; Kringas, P; Hausheer, C; Tejada, J; Gumpel, K; Kirpitch, A; Schneier, H; AbouAssi, H; Chatterjee, R; Feinglos, MN; English Jones, J; Khan, SA; Kimpel, JB; Zimmer, RP; Furst, M; Satterwhite, BM; Thacker, CR; Evans Kreider, K; Mariash, CN; Mather, KJ; Ismail, HM |
| Source: |
Circulation, vol 149, iss 13 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2024 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
4202 Epidemiology (for-2020); 42 Health Sciences (for-2020); Cardiovascular (rcdc); Heart Disease - Coronary Heart Disease (rcdc); Health Services (rcdc); Heart Disease (rcdc); Clinical Research (rcdc); Patient Safety (rcdc); Clinical Trials and Supportive Activities (rcdc); Diabetes (rcdc); Comparative Effectiveness Research (rcdc); 6.1 Pharmaceuticals (hrcs-rac); Cardiovascular (hrcs-hc); 3 Good Health and Well Being (sdg); Adult (mesh); Aged (mesh); Humans (mesh); Middle Aged (mesh); Cardiovascular Diseases (mesh); Diabetes Mellitus; Type 2 (mesh); Glucose (mesh); Heart Failure (mesh); Hypoglycemic Agents (mesh); Liraglutide (mesh); Myocardial Infarction (mesh); Sitagliptin Phosphate (mesh); Stroke (mesh); Sulfonylurea Compounds (mesh); cardiovascular diseases |
| Subject Geographic: |
993 - 1003 |
| Description: |
BACKGROUND: Cardiovascular disease is a major cause of morbidity and mortality in patients with type 2 diabetes. The effects of glucose-lowering medications on cardiovascular outcomes in individuals with type 2 diabetes and low cardiovascular risk are unclear. We investigated cardiovascular outcomes by treatment group in participants randomly assigned to insulin glargine, glimepiride, liraglutide, or sitagliptin, added to baseline metformin, in GRADE (Glycemia Reduction Approaches in Type 2 Diabetes: A Comparative Effectiveness Study). METHODS: A total of 5047 participants with a mean±SD age of 57.2±10.0 years, type 2 diabetes duration of 4.0±2.7 years, and low baseline prevalence of cardiovascular disease (myocardial infarction, 5.1%; cerebrovascular accident, 2.0%) were followed for a median of 5 years. Prespecified outcomes included between-group time-to-first event analyses of MACE-3 (composite of major adverse cardiovascular events: cardiovascular death, myocardial infarction, and stroke), MACE-4 (MACE-3+unstable angina requiring hospitalization or revascularization), MACE-5 (MACE-4+coronary revascularization), MACE-6 (MACE-5+hospitalization for heart failure), and the individual components. MACE outcomes and hospitalization for heart failure in the liraglutide-treated group were compared with the other groups combined using Cox proportional hazards models. MACE-6 was also analyzed as recurrent events using a proportional rate model to compare all treatment groups. RESULTS: We observed no statistically significant differences in the cumulative incidence of first MACE-3, MACE-4, MACE-5, or MACE-6, or their individual components, by randomized treatment group. However, when compared with the other treatment groups combined, the liraglutide-treated group had a significantly lower risk of MACE-5 (adjusted hazard ratio, 0.70 [95% CI, 0.54-0.91]; P=0.021), MACE-6 (adjusted hazard ratio, 0.70 [95% CI, 0.55-0.90]; P=0.021), and hospitalization for heart failure (adjusted hazard ratio, 0.49 [95% CI, 0.28-0.86]; ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt5hw2n6sr; https://escholarship.org/uc/item/5hw2n6sr; https://escholarship.org/content/qt5hw2n6sr/qt5hw2n6sr.pdf |
| DOI: |
10.1161/circulationaha.123.066604 |
| Availability: |
https://escholarship.org/uc/item/5hw2n6sr; https://escholarship.org/content/qt5hw2n6sr/qt5hw2n6sr.pdf; https://doi.org/10.1161/circulationaha.123.066604 |
| Rights: |
public |
| Accession Number: |
edsbas.DB42CCD0 |
| Database: |
BASE |