Effect of atorvastatin on glycaemia progression in patients with diabetes: an analysis from the Collaborative Atorvastatin in Diabetes Trial (CARDS)
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Le résumé fourni par la source
AIMS/HYPOTHESIS: In an individual-level analysis we examined the effect of atorvastatin on glycaemia progression in type 2 diabetes and whether glycaemia effects reduce the prevention of cardiovascular disease (CVD) with atorvastatin. METHODS: The study population comprised 2,739 people taking part in the Collaborative Atorvastatin Diabetes Study (CARDS) who were randomised to receive atorvastatin 10 mg or placebo and who had post-randomisation HbA1c data. This secondary analysis used Cox regression to estimate the effect of atorvastatin on glycaemia progression, defined as an increase in HbA1c of ≥ 0.5% (5.5 mmol/mol) or intensification of diabetes therapy. Mixed models were used to estimate the effect of atorvastatin on HbA1c as a continuous endpoint. RESULTS: Glycaemia progression occurred in 73.6% of participants allocated placebo and 78.1% of those allocated atorvastatin (HR 1.18 [95% CI 1.08, 1.29], p < 0.001) by the end of follow-up. The HR was 1.22 (95% CI 1.19, 1.35) in men and 1.11 (95% CI 0.95, 1.29) in women (p = 0.098 for the sex interaction). A similar effect was seen in on-treatment analyses: HR 1.20 (95% CI 1.07, 1.35), p = 0.001. The net mean treatment effect on HbA1c was 0.14% (95% CI 0.08, 0.21) (1.5 mmol/mol). The effect did not increase through time. Diabetes treatment intensification alone did not differ with statin allocation. Neither baseline nor 1-year-attained HbA1c predicted subsequent CVD, and the atorvastatin effect on CVD did not vary by HbA1c change (interaction p value 0.229). CONCLUSIONS/INTERPRETATION: The effect of atorvastatin 10 mg on glycaemia progression among those with diabetes is statistically significant but very small, is not significantly different between sexes, does not increase with duration of statin and does not have an impact on the magnitude of CVD risk reduction with atorvastatin.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Effect of atorvastatin on glycaemia progression in patients with diabetes: an analysis from the Collaborative Atorvastatin in Diabetes Trial (CARDS)
- Date Crossref
- 17/11/2015
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Dundee Division of Population Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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University College Hospital Department of Endocrinology and Diabetes pays non établi dans la noticeÉtablissement de santé
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University College London Department of Epidemiology and Public Health pays non établi dans la noticeUniversité ou école supérieure
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University of Manchester pays non établi dans la noticeUniversité ou école supérieure
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Queen Mary University of London pays non établi dans la noticeUniversité ou école supérieure
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Blizard Institute pays non établi dans la noticeUniversité ou école supérieure
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University of Oxford Endocrinology and Metabolism pays non établi dans la noticeUniversité ou école supérieure
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Oxford Centre for Diabetes pays non établi dans la noticeStructure de recherche
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School of Biosciences Cardiovascular Research Group pays non établi dans la noticeUniversité ou école supérieure
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Barts and the London School of Medicine Blizard Institute pays non établi dans la noticeUniversité ou école supérieure
Division of Population Health Sciences — University of Dundee, Department of Endocrinology and Diabetes — University College Hospital et Department of Epidemiology and Public Health — University College London, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.