Qualifying Event Proximity, Cardiovascular Risk, and Benefit of Empagliflozin in Patients with Type 2 Diabetes and Stable Atherosclerosis in the EMPA-REG OUTCOME Trial

Background: In type 2 diabetes, the temporal proximity of an atherosclerotic cardiovascular (CV) event can impact prognosis, but whether timing influences sodium glucose co-transporter 2 inhibitor effects is unknown. We explored the association of time from last qualifying CV event before randomization (myocardial infarction [MI], stroke, coronary artery disease or peripheral arterial disease) with CV outcomes and benefit of empagliflozin (EMPA) in EMPA-REG OUTCOME.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: 416 Source Type: research

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By WILLIAM H. BESTERMANN JR., MD New Scientific Breakthroughs Can Provide a Longer Healthier Life Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biol...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients aging chronic disease Denmark Diabetes William Bestermann Source Type: blogs
CONCLUSIONS: Canagliflozin significantly reduced major cardiovascular events, as well as kidney failure, in patients with type 2 diabetes and chronic kidney disease, including in participants who did not have prior cardiovascular disease. CLINICAL TRIAL REGISTRATION: URL: https://ClinicalTrials.gov Unique identifier: NCT02065791. PMID: 31291786 [PubMed - as supplied by publisher]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
CONCLUSIONS: Positive patient experiences of practitioner empathy in the year after diagnosis of type 2 diabetes may be associated with beneficial long-term clinical outcomes. Further work is needed to understand which aspects of patient perceptions of empathy might influence health outcomes and how to incorporate this understanding into the education and training of practitioners. PMID: 31285208 [PubMed - in process]
Source: Annals of Family Medicine - Category: Primary Care Authors: Tags: Ann Fam Med Source Type: research
Abstract Patients with type 2 diabetes mellitus (T2DM) have a very high risk of cardiovascular related events, and reducing complications is an important evaluation criterion of efficacy and safety of hypoglycemic drugs. Previous studies have shown that the dipeptidyl peptidase-4 inhibitors (DPP4i), such as sitagliptin, might reduce the incidence of major cardiovascular events (MACE). However, the safety and efficacy of sitagliptin remains controversial, especially the safety for cardiovascular related events. Here, a systematic review was conducted to assess the cardiovascular safety of sitagliptin in T2DM patien...
Source: Bioscience Reports - Category: Biomedical Science Authors: Tags: Biosci Rep Source Type: research
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Authors: Tanner C, Wang G, Liu N, Andrikopoulos S, Zajac JD, Ekinci EI Abstract ■Metformin is recommended as first-line therapy for type 2 diabetes because of its safety, low cost and potential cardiovascular benefits. ■The use of metformin was previously restricted in people with chronic kidney disease (CKD) - a condition that commonly coexists with diabetes - due to concerns over drug accumulation and metformin-associated lactic acidosis. ■There are limited data from observational studies and small randomised controlled trials to suggest that metformin, independent of its antihyperglycaemic effects, may be ...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
Publication date: Available online 9 June 2019Source: The LancetAuthor(s): Hertzel C Gerstein, Helen M Colhoun, Gilles R Dagenais, Rafael Diaz, Mark Lakshmanan, Prem Pais, Jeffrey Probstfield, Fady T Botros, Matthew C Riddle, Lars Rydén, Denis Xavier, Charles Messan Atisso, Leanne Dyal, Stephanie Hall, Purnima Rao-Melacini, Gloria Wong, Alvaro Avezum, Jan Basile, Namsik Chung, Ignacio CongetSummaryBackgroundTwo glucagon-like peptide-1 (GLP-1) receptor agonists reduced renal outcomes in people with type 2 diabetes at risk for cardiovascular disease. We assessed the long-term effect of the GLP-1 receptor agonist dulag...
Source: The Lancet - Category: General Medicine Source Type: research
This study is registered with ClinicalTrials.gov, number NCT01394952.FindingsBetween Aug 18, 2011, and Aug 14, 2013, 9901 participants (mean age 66·2 years [SD 6·5], median HbA1c 7·2% [IQR 6·6–8·1], 4589 [46·3%] women) were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). During a median follow-up of 5·4 years (IQR 5·1–5·9), the primary composite outcome occurred in 594 (12·0%) participants at an incidence rate of 2·4 per 100 person-years in the dulaglutide group and in 663 (13·4%) participants...
Source: The Lancet - Category: General Medicine Source Type: research
ConclusionsThis meta-analysis demonstrated that GLP-1RAs were associated with a significant reduction in major adverse CV events, CV death, stroke and death from any cause, while DPP-4 inhibitors were comparable to placebo for all CV outcomes, including hospitalizations for heart failure.RésuméObjectifsLes auteurs de deux grands essais randomisés ont récemment publié leurs conclusions concernant les effets d'un agoniste du récepteur au glucagon-like peptide-1 (A-GLP-1R) (essai HARMONY) et d'un inhibiteur de la dipeptidyl peptidase 4 (DPP-4) (essai CARMELINA) sur les b&eac...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
A, Lima LM Abstract Various forms of vascular injury are frequently associated with type-2 diabetes mellitus (DM2). Macro-angiopathy has alarming signs and symptoms such as those seen with stroke or heart attack, however the presentation of small vessel disease is generally more subtle and therefore usually unnoticed for a long period of time. While it may affect any organ, complications involving the nervous system such as diabetic poly-neuropathy (DPN) are especially debilitating, and it may also be a risk factor for other brain disorders such as dementia. The underlying mechanisms are likely to be multi-facete...
Source: Brain Research Bulletin - Category: Neurology Authors: Tags: Brain Res Bull Source Type: research
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