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Basal insulin and cardiovascular and other outcomes in dysglycemia.
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In: New England Journal of Medicine, vol. 367, no. 4, pp. 319-328 (2012)
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n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia.
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Bosch, J.; Gerstein, H.C.; Dagenais, G.R.; Díaz, R.; Dyal, L.; Jung, H.; Maggiono, A.P.; Probstfield, J.; Ramachandran, A.; Riddle, M.C.; Rydén, L.E.; Yusuf, S.
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In: New England Journal of Medicine, vol. 367, no. 4, pp. 309-318 (2012)
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Abstract:
BACKGROUND: The use of n-3 fatty acids may prevent cardiovascular events in patients with recent myocardial infarction or heart failure. Their effects in patients with (or at risk for) type 2 diabetes mellitus are unknown. METHODS: In this double-blind study with a 2-by-2 factorial design, we randomly assigned 12,536 patients who were at high risk for cardiovascular events and had impaired fasting glucose, impaired glucose tolerance, or diabetes to receive a 1-g capsule containing at least 900 mg (90% or more) of ethyl esters of n-3 fatty acids or placebo daily and to receive either insulin glargine or standard care. The primary outcome was death from cardiovascular causes. The results of the comparison between n-3 fatty acids and placebo are reported here. RESULTS: During a median follow up of 6.2 years, the incidence of the primary outcome was not significantly decreased among patients receiving n-3 fatty acids, as compared with those receiving placebo (574 patients [9.1%] vs. 581 patients [9.3%]; hazard ratio, 0.98; 95% confidence interval [CI], 0.87 to 1.10; P=0.72). The use of n-3 fatty acids also had no significant effect on the rates of major vascular events (1034 patients [16.5%] vs. 1017 patients [16.3%]; hazard ratio, 1.01; 95% CI, 0.93 to 1.10; P=0.81), death from any cause (951 [15.1%] vs. 964 [15.4%]; hazard ratio, 0.98; 95% CI, 0.89 to 1.07; P=0.63), or death from arrhythmia (288 [4.6%] vs. 259 [4.1%]; hazard ratio, 1.10; 95% CI, 0.93 to 1.30; P=0.26). Triglyceride levels were reduced by 14.5 mg per deciliter (0.16 mmol per liter) more among patients receiving n-3 fatty acids than among those receiving placebo (P<0.001), without a significant effect on other lipids. Adverse effects were similar in the two groups. CONCLUSIONS: Daily supplementation with 1 g of n-3 fatty acids did not reduce the rate of cardiovascular events in patients at high risk for cardiovascular events. (Funded by Sanofi; ORIGIN ClinicalTrials.gov number, NCT00069784.).
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Keyword:
Aged; Cardiovascular Diseases/etiology; Cardiovascular Diseases/mortality; Cholesterol/blood; Combination; Diabetes Mellitus; Double-Blind Method; Drug Therapy; Fatty Acids; Female; Follow-Up Studies; Glucose Intolerance/complications; Glucose Intolerance/drug therapy; Humans; Hypoglycemic Agents/therapeutic use; Incidence; Insulin; Intention to Treat Analysis; Long-Acting/therapeutic use; Male; Middle Aged; Omega-3/therapeutic use; Proportional Hazards Models; Treatment Failure; Triglycerides/blood; Type 2/complications; Type 2/drug therapy
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URL: https://doi.org/10.1056/NEJMoa1203859
https://serval.unil.ch/notice/serval:BIB_83A3987D7CC1
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Cardiorenal end points in a trial of aliskiren for type 2 diabetes.
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In: New England Journal of Medicine, vol. 367, no. 23, pp. 2204-2213 (2012)
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CT colonography and computer-aided detection: effect of false-positive results on reader specificity and reading efficiency in a low-prevalence screening population.
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In: Radiology , 247 (1) pp. 133-140. (2008) (2008)
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