Diabetes, Other Risk Factors, and 12-Yr Cardiovascular Mortality for Men Screened in the Multiple Risk Factor Intervention Trial

Stamler, Jeremiah; Vaccaro, Olga; Neaton, James D.; Wentworth, Deborah

doi:10.2337/diacare.16.2.434

Cited by 3,644 publications

(2,184 citation statements)

References 42 publications

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“…Several studies have recently assessed the relationship between type 2 diabetes and the risk of stroke. Type 2 diabetes has been shown to be an independent risk factor for stroke morbidity [15,[18][19][20][21][22] and mortality [14,16,17,22,40]. The Renfrew and Paisley Study found that type 2 diabetes was a predictor of stroke incidence among women but not among men [41].…”

Section: Discussionmentioning

confidence: 99%

“…Several prospective studies have assessed the independent effect of type 2 diabetes on stroke risk, with inconsistent results. Some [14][15][16][17][18][19][20][21][22], but not all studies [23,24], have identified type 2 diabetes as an independent risk factor for stroke. Moreover, it is not fully understood whether the risk of stroke death associated with incident diabetes is similar to that associated with incident stroke.…”

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confidence: 99%

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The effect of diabetes and stroke at baseline and during follow-up on stroke mortality

Jousilahti

Sarti

et al. 2006

Diabetologia

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Aims/hypothesis The aim of this study was to compare the magnitude of the effect of diabetes and stroke at baseline and during follow-up on risk of stroke mortality. Materials and methods Study cohorts included 25,155 Finnish men and 26,423 women aged 25-74 years. Data on diabetes and stroke history at baseline, their incidence during follow-up, and stroke death were obtained from national registers. Results During a mean follow-up of 18.9 years, 838 stroke deaths were recorded. In the baseline study, hazard ratios (HRs) for stroke mortality were 5.26 for men with prior diabetes only, 4.76 for men with prior stroke only, and 13.4 for men with both prior diabetes and stroke compared with men without diabetes and stroke at baseline and during follow-up. In women, the corresponding hazard ratios were 7.29, 5.27 and 5.52, respectively. When only diabetes and stroke status during the follow-up were considered, the hazard ratios for stroke mortality were 1.41 for men and 1.56 for women with incident diabetes only, 5.62 for men and 5.58 for women with incident stroke only, and 5.59 for men and 4.48 for women with both incident diabetes and stroke compared with men and women without diabetes and stroke at baseline and during follow-up. Conclusions/interpretation Diabetes and stroke, present either at baseline or during follow-up, markedly increase the risk of stroke death. Prior stroke at baseline carries a similar risk of stroke mortality as prior diabetes. There is a greater risk of stroke mortality associated with incident stroke during follow-up than with incident diabetes.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The effect of diabetes and stroke at baseline and during follow-up on stroke mortality

Jousilahti

Sarti

et al. 2006

Diabetologia

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“…2,3 Epidemiological analyses of United Kingdom Prospective Diabetes Study data from newly-diagnosed T2DM identified higher low-density lipoprotein cholesterol, lower highdensity lipoprotein cholesterol, hyperglycemia, hypertension, and smoking as potentially modifiable cardiovascular risk factors. 4 However, even after adjustment for these factors, people with T2DM remain at double the cardiovascular risk as those without T2DM.…”

Section: Introductionmentioning

confidence: 99%

Rationale and design of the EXenatide Study of Cardiovascular Event Lowering (EXSCEL) trial

Holman

Bethel

George

et al. 2016

American Heart Journal

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The primary efficacy hypothesis is that exenatide once-weekly is superior to usual care with respect to the primary composite cardiovascular endpoint. EXSCEL is powered to detect a 15% relative risk reduction in the exenatide once weekly group, with 85% power and a 2-sided 5% alpha. The primary safety hypothesis is that exenatide onceweekly is noninferior to usual care with respect to the primary cardiovascular composite endpoint. Noninferiority will be concluded if the upper limit of the confidence interval is <1.30. 4EXSCEL will assess whether exenatide once-weekly can reduce cardiovascular events in patients with T2DM with a broad range of cardiovascular risk. It will also provide longterm safety information on exenatide once-weekly in people with T2DM. ClinicalTrials.gov Identifier: NCT011443385

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“…It is well documented that patients with type 2 diabetes have an increased risk of cardiovascular disease (CVD) [1]. Several independent risk markers for the development of CVD in patients with diabetes have been identified, e.g., hyperglycaemia, hypertension, hypercholesterolaemia, smoking and microalbuminuria.…”

Section: Introductionmentioning

confidence: 99%

Plasma N-terminal pro-brain natriuretic peptide as a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria

et al. 2004

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Aims/hypothesis: We examined whether plasma N-terminal probrain natriuretic peptide (NT-proBNP) predicts cardiovascular outcome in patients with type 2 diabetes. Methods: A total of 160 microalbuminuric type 2 diabetic patients (mean age 55.1 years [SD 7.2], 119 men) were enrolled in the Steno-2 Study examining the effect of multifactorial treatment, and were divided into two groups according to baseline levels of plasma NTproBNP below or above the median for the cohort, which was followed for an average of 7.8 years. Cardiovascular outcome was a composite of cardiovascular mortality, myocardial infarction, stroke, revascularisation procedures in the heart or legs, and amputations. Results: In the whole group, plasma NT-proBNP being above the median was associated with an increased risk of cardiovascular disease during follow-up, with an unadjusted hazard ratio of 4.4 (95% CI 2.3-8.4; p<0.0001). A decrease in plasma NT-proBNP of 10 pg/ml during the first 2 years of intervention was associated with a 1% relative reduction in the primary endpoint (p<0.001). Despite polypharmacological treatment targeting cardiovascular disease, the mean plasma NT-proBNP level increased during followup. Conclusions/interpretation: We conclude that high plasma NT-proBNP is a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria.

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Diabetes, Other Risk Factors, and 12-Yr Cardiovascular Mortality for Men Screened in the Multiple Risk Factor Intervention Trial

Abstract: These findings emphasize the importance of rigorous sustained intervention in people with diabetes to control blood pressure, lower serum cholesterol, and abolish cigarette smoking, and the importance of considering nutritional-hygienic approaches on a mass scale to prevent diabetes.

Cited by 3,644 publications

References 42 publications

The effect of diabetes and stroke at baseline and during follow-up on stroke mortality

The effect of diabetes and stroke at baseline and during follow-up on stroke mortality

Rationale and design of the EXenatide Study of Cardiovascular Event Lowering (EXSCEL) trial

Plasma N-terminal pro-brain natriuretic peptide as a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria

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