Evaluation of the HbA1c Reduction Cut Point for a Nonglycemic Effect on Cardiovascular Benefit of Hypoglycemic Agents in Patients with Type 2 Diabetes Based on Endpoint Events

المؤلفون المشاركون

Wu, Yuchao
Tang, Lizhi
Zhang, Fang
Yan, Zhe
Li, Jing
Tong, Nanwei

المصدر

International Journal of Endocrinology

العدد

المجلد 2018، العدد 2018 (31 ديسمبر/كانون الأول 2018)، ص ص. 1-7، 7ص.

الناشر

Hindawi Publishing Corporation

تاريخ النشر

2018-04-19

دولة النشر

مصر

عدد الصفحات

7

التخصصات الرئيسية

الأحياء

الملخص EN

Background.

Atherosclerotic cardiovascular disease (ASCVD) is a major cause of death among patients with diabetes but can be improved by certain hypoglycemic agents.

However, adjudicating criteria on whether improvements are a glycemic or nonglycemic effect of these agents remain unclear.

Methods.

Hypoglycemic agents that produce a cardiovascular benefit in nondiabetic patients are considered to do so via a nonglycemic effect.

We performed a subgroup analysis for primary and secondary prevention or very high risk of ASCVD in patients with type 2 diabetes (T2DM).

Where glycosylated hemoglobin (HbA1c) was reduced to the same extent in a head-to-head comparison, cardiovascular benefits were judged as a nonglycemic effect.

Furthermore, by analyzing the endpoints of four important randomized controlled intensive glucose control studies, UKPDS33, ADVANCE, ACCORD, and VADT, we calculated the cut point of HbA1c reduction for a nonglycemic effect on cardiovascular benefit by hypoglycemic agents in ASCVD groups of different severities.

Results.

For the ASCVD primary prevention group of T2DM, UKPDS33 indicated a reduction in HbA1c < 0.9%, and a cardiovascular benefit within 10 years was considered a nonglycemic effect.

For ASCVD secondary prevention or in the very high-risk group, pioglitazone exerted a nonglycemic effect on cardiovascular benefit in nondiabetic patients with insulin resistance; metformin may exert a similar effect in T2DM patients in a head-to-head study.

Analysis of T2DM intensive glucose control studies showed a reduction in HbA1c of <1.0%, and a cardiovascular benefit after approximately 5 years was deemed a nonglycemic effect.

Conclusions.

For ASCVD primary prevention in T2DM, a reduction in HbA1c < 0.9% and a cardiovascular benefit within 10 years were considered a nonglycemic effect.

For ASCVD secondary prevention or in a very high-risk population, a reduction in HbA1c < 1.0% and a cardiovascular benefit within about 5 years were also considered a nonglycemic effect.

نمط استشهاد جمعية علماء النفس الأمريكية (APA)

Wu, Yuchao& Tang, Lizhi& Zhang, Fang& Yan, Zhe& Li, Jing& Tong, Nanwei. 2018. Evaluation of the HbA1c Reduction Cut Point for a Nonglycemic Effect on Cardiovascular Benefit of Hypoglycemic Agents in Patients with Type 2 Diabetes Based on Endpoint Events. International Journal of Endocrinology،Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1172164

نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)

Wu, Yuchao…[et al.]. Evaluation of the HbA1c Reduction Cut Point for a Nonglycemic Effect on Cardiovascular Benefit of Hypoglycemic Agents in Patients with Type 2 Diabetes Based on Endpoint Events. International Journal of Endocrinology No. 2018 (2018), pp.1-7.
https://search.emarefa.net/detail/BIM-1172164

نمط استشهاد الجمعية الطبية الأمريكية (AMA)

Wu, Yuchao& Tang, Lizhi& Zhang, Fang& Yan, Zhe& Li, Jing& Tong, Nanwei. Evaluation of the HbA1c Reduction Cut Point for a Nonglycemic Effect on Cardiovascular Benefit of Hypoglycemic Agents in Patients with Type 2 Diabetes Based on Endpoint Events. International Journal of Endocrinology. 2018. Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1172164

نوع البيانات

مقالات

لغة النص

الإنجليزية

الملاحظات

Includes bibliographical references

رقم السجل

BIM-1172164