Abstract
We performed a meta-analysis of studies evaluating the effect of intensive glucose control on major adverse cardiovascular events in patients with type 2 diabetes from 1990 to 2009. A search of the published literature and the Cochran Central Register for Controlled Trials was performed using pre-specified inclusion criteria consisting of randomised controlled trials evaluating intensive glycaemic control and reporting the individual endpoints of all-cause mortality, nonfatal myocardial infarction, and non-fatal stroke. Incident rate ratios for these endpoints were calculated using standard meta-analytic techniques of pooled data from eligible trials. Six reports from four randomised trials including 27,544 patients met the pre-specified inclusion criteria. Mean follow-up was 5.4 years; haemoglobin AIC at study end was 6.6% vs. 7.4% in patients randomised to intensive compared with conventional glucose control. Intensive glucose control did not affect the incident rate ratio for all-cause mortality (1.01, 95% confidence interval 0.86-1.18, p=0.54) or stroke (1.02, 95% confidence interval 0.88-1.20, p=0.62). However, there was a statistically significant 14% reduction in nonfatal myocardial infarction in patients randomised to intensive glucose control (0.86, 95% confidence interval 0.77-0.97, p=0.0I5). Although intensification of glucose control did not affect mortality or non-fatal stroke, the risk for non-fatal myocardial infarction was significantly reduced in patients with type 2 diabetes.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 119-130 |
| Number of pages | 12 |
| Journal | Diabetes and Vascular Disease Research |
| Volume | 7 |
| Issue number | 2 |
| DOIs | |
| State | Published - Apr 2010 |
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Keywords
- Diabetes mellitus
- Glucose lowering
- MACE
- Macrovascular complications
- Mortality
- Myocardial infarction
- Stroke
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Internal Medicine
- Cardiology and Cardiovascular Medicine
- Medicine(all)
Cite this
The effect of intensive glucose control on all-cause and cardiovascular mortality, myocardial infarction and stroke in persons with type 2 diabetes mellitus : A systematic review and meta-analysis. / Marso, Steven P.; Kennedy, Kevin F.; House, John A.; McGuire, Darren K.
In: Diabetes and Vascular Disease Research, Vol. 7, No. 2, 04.2010, p. 119-130.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The effect of intensive glucose control on all-cause and cardiovascular mortality, myocardial infarction and stroke in persons with type 2 diabetes mellitus
T2 - A systematic review and meta-analysis
AU - Marso, Steven P.
AU - Kennedy, Kevin F.
AU - House, John A.
AU - McGuire, Darren K.
PY - 2010/4
Y1 - 2010/4
N2 - We performed a meta-analysis of studies evaluating the effect of intensive glucose control on major adverse cardiovascular events in patients with type 2 diabetes from 1990 to 2009. A search of the published literature and the Cochran Central Register for Controlled Trials was performed using pre-specified inclusion criteria consisting of randomised controlled trials evaluating intensive glycaemic control and reporting the individual endpoints of all-cause mortality, nonfatal myocardial infarction, and non-fatal stroke. Incident rate ratios for these endpoints were calculated using standard meta-analytic techniques of pooled data from eligible trials. Six reports from four randomised trials including 27,544 patients met the pre-specified inclusion criteria. Mean follow-up was 5.4 years; haemoglobin AIC at study end was 6.6% vs. 7.4% in patients randomised to intensive compared with conventional glucose control. Intensive glucose control did not affect the incident rate ratio for all-cause mortality (1.01, 95% confidence interval 0.86-1.18, p=0.54) or stroke (1.02, 95% confidence interval 0.88-1.20, p=0.62). However, there was a statistically significant 14% reduction in nonfatal myocardial infarction in patients randomised to intensive glucose control (0.86, 95% confidence interval 0.77-0.97, p=0.0I5). Although intensification of glucose control did not affect mortality or non-fatal stroke, the risk for non-fatal myocardial infarction was significantly reduced in patients with type 2 diabetes.
AB - We performed a meta-analysis of studies evaluating the effect of intensive glucose control on major adverse cardiovascular events in patients with type 2 diabetes from 1990 to 2009. A search of the published literature and the Cochran Central Register for Controlled Trials was performed using pre-specified inclusion criteria consisting of randomised controlled trials evaluating intensive glycaemic control and reporting the individual endpoints of all-cause mortality, nonfatal myocardial infarction, and non-fatal stroke. Incident rate ratios for these endpoints were calculated using standard meta-analytic techniques of pooled data from eligible trials. Six reports from four randomised trials including 27,544 patients met the pre-specified inclusion criteria. Mean follow-up was 5.4 years; haemoglobin AIC at study end was 6.6% vs. 7.4% in patients randomised to intensive compared with conventional glucose control. Intensive glucose control did not affect the incident rate ratio for all-cause mortality (1.01, 95% confidence interval 0.86-1.18, p=0.54) or stroke (1.02, 95% confidence interval 0.88-1.20, p=0.62). However, there was a statistically significant 14% reduction in nonfatal myocardial infarction in patients randomised to intensive glucose control (0.86, 95% confidence interval 0.77-0.97, p=0.0I5). Although intensification of glucose control did not affect mortality or non-fatal stroke, the risk for non-fatal myocardial infarction was significantly reduced in patients with type 2 diabetes.
KW - Diabetes mellitus
KW - Glucose lowering
KW - MACE
KW - Macrovascular complications
KW - Mortality
KW - Myocardial infarction
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=77954478975&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954478975&partnerID=8YFLogxK
U2 - 10.1177/1479164109353367
DO - 10.1177/1479164109353367
M3 - Article
C2 - 20382775
AN - SCOPUS:77954478975
VL - 7
SP - 119
EP - 130
JO - Diabetes and Vascular Disease Research
JF - Diabetes and Vascular Disease Research
SN - 1479-1641
IS - 2
ER -