Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events

Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events

Autor McMurray, John J. Google Scholar
Holman, Rury R. Google Scholar
Haffner, Steven M. Google Scholar
Bethel, M. Angelyn Google Scholar
Holzhauer, Bjoern Google Scholar
Hua, Tsushung A. Google Scholar
Belenkov, Yuri Google Scholar
Boolell, Mitradev Google Scholar
Buse, John B. Google Scholar
Buckley, Brendan M. Google Scholar
Chacra, Antonio R. Autor UNIFESP Google Scholar
Chiang, Fu-Tien Google Scholar
Charbonnel, Bernard Google Scholar
Chow, Chun-Chung Google Scholar
Davies, Melanie J. Google Scholar
Deedwania, Prakash Google Scholar
Diem, Peter Google Scholar
Einhorn, Daniel Google Scholar
Fonseca, Vivian Google Scholar
Fulcher, Gregory R. Google Scholar
Gaciong, Zbigniew Google Scholar
Gaztambide, Sonia Google Scholar
Giles, Thomas Google Scholar
Horton, Edward Google Scholar
Ilkova, Hasan Google Scholar
Jenssen, Trond Google Scholar
Kahn, Steven E. Google Scholar
Krum, Henry Google Scholar
Laakso, Markku Google Scholar
Leiter, Lawrence A. Google Scholar
Levitt, Naomi S. Google Scholar
Mareev, Viacheslav Google Scholar
Martinez, Felipe Google Scholar
Masson, Chantal Google Scholar
Mazzone, Theodore Google Scholar
Meaney, Eduardo Google Scholar
Nesto, Richard Google Scholar
Pan, Changyu Google Scholar
Prager, Rudolf Google Scholar
Raptis, Sotirios A. Google Scholar
Rutten, Guy E. H. M. Google Scholar
Sandstroem, Herbert Google Scholar
Schaper, Frank Google Scholar
Scheen, Andre Google Scholar
Schmitz, Ole Google Scholar
Sinay, Isaac Google Scholar
Soska, Vladimir Google Scholar
Stender, Steen Google Scholar
Tamas, Gyula Google Scholar
Tognoni, Gianni Google Scholar
Tuomilehto, Jaako Google Scholar
Villamil, Alberto S. Google Scholar
Vozar, Juraj Google Scholar
Califf, Robert M. Google Scholar
NAVIGATOR Study Grp Google Scholar
Instituição Univ Glasgow
Univ Oxford
Univ Texas Hlth Sci Ctr San Antonio
Duke Univ
Novartis Pharmaceut
Moscow MV Lomonosov State Univ
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Diabetol Outpatient Clin
Resumo BACKGROUNDIt is not known whether drugs that block the renin-angiotensin system reduce the risk of diabetes and cardiovascular events in patients with impaired glucose tolerance.METHODSIn this double-blind, randomized clinical trial with a 2-by-2 factorial design, we assigned 9306 patients with impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors to receive valsartan (up to 160 mg daily) or placebo (and nateglinide or placebo) in addition to lifestyle modification. We then followed the patients for a median of 5.0 years for the development of diabetes (6.5 years for vital status). We studied the effects of valsartan on the occurrence of three coprimary outcomes: the development of diabetes; an extended composite outcome of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, arterial revascularization, or hospitalization for unstable angina; and a core composite outcome that excluded unstable angina and revascularization.RESULTSThe cumulative incidence of diabetes was 33.1% in the valsartan group, as compared with 36.8% in the placebo group (hazard ratio in the valsartan group, 0.86; 95% confidence interval [CI], 0.80 to 0.92; P<0.001). Valsartan, as compared with placebo, did not significantly reduce the incidence of either the extended cardiovascular outcome (14.5% vs. 14.8%; hazard ratio, 0.96; 95% CI, 0.86 to 1.07; P = 0.43) or the core cardiovascular outcome (8.1% vs. 8.1%; hazard ratio, 0.99; 95% CI, 0.86 to 1.14; P = 0.85).CONCLUSIONSAmong patients with impaired glucose tolerance and cardiovascular disease or risk factors, the use of valsartan for 5 years, along with lifestyle modification, led to a relative reduction of 14% in the incidence of diabetes but did not reduce the rate of cardiovascular events. (ClinicalTrials.gov number, NCT00097786.)
Idioma Inglês
Financiador Novartis Pharma
Data de publicação 2010-04-22
Publicado em New England Journal of Medicine. Waltham: Massachusetts Medical Soc, v. 362, n. 16, p. 1477-1490, 2010.
ISSN 0028-4793 (Sherpa/Romeo, fator de impacto)
Publicador Massachusetts Medical Soc
Extensão 1477-1490
Fonte http://dx.doi.org/10.1056/NEJMoa1001121
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000276894700007
Endereço permanente http://repositorio.unifesp.br/handle/11600/32479

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