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Diabetes Care. 2008 May;31(5):1007-14. doi: 10.2337/dc07-1868. Epub 2008 Feb 11.

Effects of ramipril and rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose: results of the Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) trial.

Collaborators (941)

Gerstein HC, Yusuf S, Holman RR, Bosch J, Anand S, Avezum A, Budaj A, Chiasson JL, Conget I, Dagenais G, Davies M, Diaz R, Dinccag N, Enjalbert M, Escalante A, Fodor G, Hanefeld M, Hedner T, Jolly K, Keltai M, Laakso M, Lanas F, Lonn E, McQueen M, Mohan V, Phillips A, Piegas L, Piegas V, Probstfield J, Schmid I, Shaw J, Teo K, Zimmet P, Zinman B, Diaz R, Guerrero RA, Albisu J, Alvarez MS, Arregui V, Avaca H, Baglivo H, Balbuena M, Bello F, Bono J, Botto M, Brandani L, Brandes M, Bruera D, Venere RC, Caccavo A, Cacurri A, Caime G, Capozzi M, Carrique A, Carrique P, Cartasegna L, Casabe J, Casaccia G, Castellanos C, Castro L, Cendali G, Cerchi P, Cerdan M, Cinalli M, Cipullo M, Cismondi M, Citta N, Citta L, Crespo C, Crunger P, Cuneo C, De Loredo L, De Loredo S, del Cerro S, Denaro R, Esperatti E, Esposito L, Farras H, Fernandez S, Fernandez M, Fernandez A, Ferrari G, Focaccia M, Frontini L, Gabito A, Gambarte A, Garrido M, Garrido I, Guglielmotti V, Hershson A, Hoffman V, Juarisit G, Klyver M, Lagrutta M, Llanos J, Liberman A, Marquez LL, Lopez R, Lowenstein D, Lowenstein J, Lucero C, Luciardi H, Clos EL, Luna M, Luquez C, MacKinnon I, Maffia M, Mahfoud C, Majul C, Maldonado N, Manuale O, Marcucci G, Martin S, Martinez G, Martos M, Marzetti E, Memoli R, Molina M, Montana O, Morales S, Morell Y, Navarrete S, Nieto F, Ocampo L, Orce R, Orlandini A, Oteiza E, Pepa C, Piasentin J, Piskorz D, Plastino M, Pomposiello J, Quiroga G, Ramos F, Ramos H, Reissig F, Risolo A, Riverso Z, Rodrigues H, Rodriquez C, Saavedra S, Sago L, Sanchez R, Schwindt C, Schygiel P, Sebastian F, Sposetti G, Streitenberger P, Suarez G, Suzrez F, Vico M, Vignau S, Visco V, Castro AV, Zaidman C, Shaw J, Zimmet P, Allen C, Arsov T, Bartlett N, Batrouney B, Borger R, Brooks B, Buchanan P, Buckland A, Calvert D, Carr J, Chan Y, Ching H, Chronopoulos A, Coates P, Cohen N, Colagiuri S, Colman P, Correcha M, d'Emden M, Ding G, Edwards W, Estensen K, Fitzpatrick B, Freeborn J, Friebel H, Fulcher G, Garland C, Gauld A, Gein J, Glatthaar C, Graham J, Gronan A, Gunser A, Hackney P, Hall C, Hay L, Heazlewood V, Heyward D, Higgins B, Hines M, Hodge A, Honisett S, Jovanovska A, Karrasch J, Kean M, Lawton M, Lee C, Legg H, Long F, Lucas E, Lynch L, Marangou A, Margrie F, Martin L, McKenzie J, McKinnon A, McNamara M, Mencel J, Moses R, Murphy C, Naidu V, Nairn J, Nankervis A, Nattrass N, Ngweso A, Nugent T, O'Brien R, Palmer N, Parry H, Pasculli K, Patrikios P, Perampalam S, Phillips J, Phillips S, Por E, Pringle S, Prior E, Proietto J, Rando L, Ridley D, Roberts A, Robertson P, Robinson K, Rodgers C, Ross G, Rowe J, Siddall R, Silva D, Simpson R, Slobodniuk R, Smith G, Socha L, Soden V, Speedy M, Spence E, Steed K, Stephens C, Stewart R, Stuckey B, Sumithran P, Sunderland J, Tapp E, Tejani N, Tong C, Topliss D, Tran H, Vanlint S, Wagner J, Walsh J, Warner J, Webb A, Welborn T, Wentworth J, White C, Wigg S, Willenberg V, Wilson D, Wood M, Wu S, Yue D, Yuen R, Marshall S, Baillie E, Campbell G, Cressall J, Heir J, Jones D, Myrie J, Watlington M, West A, Avezum A, Piegas L, Bertolami M, Borges J, de Araujo DB, Cartena L, de Campos Salvarani N, Faludi A, Telo DF, Grespan S, Gross J, Halpern A, Hirota A, Maeda S, Monte O, Nakamura Y, Salles JN, Oliveira O, Pinto C, Rabelo L, Rabelo A Jr, Silveiro S, Turatti L, Zatz H, Zoubel V, Abbott C, Abu-Bakare A, Allison R, Anand S, Anderlic T, Auger D, Barnie A, Beauchef J, Beers S, Belanger A, Beliveau L, Berard L, Bolduc H, Bondy G, Bradley J, Bragaglia P, Brault S, Brittain M, Brossoit R, Brown S, Capes S, Carmichael P, Caron D, Caruana L, Cha J, Champion P, Chan S, Chan Y, Chausse I, Cheung R, Chiasson JL, Chilvers M, Chisholm S, Clearwaters M, Colborne C, Conway J, Czolpinski T, Dallaire S, David M, Davis A, DeAngelis D, Delpech I, Denton R, Dufour A, Dunn P, Duong H, Eddy D, Erickson-Nesmith S, Fay D, Fox G, Frohlich J, Fyfe M, Galandzy S, Gauthier S, Gillett J, Girard G, Gosselin G, Gourgues M, Gray S, Grunbaum D, Gupta M, Halle J, Hanley A, Hardin P, Harris S, Harvey N, Hoag G, Hogard M, Houlden R, Hughes D, Hunt D, Janzen L, Jenkins O, Krider J, Kwan S, Lai C, Lam A, Lambing L, Lau D, Lavallee C, Lavallee P, LeDrew G, Lee H, Legare C, Leong W, Lesperance D, Lochnan H, Ludwig S, MacNair D, Mann S, Marin M, MacFadyen J, MacLean S, Marucci J, Masson C, Maurice P, Mawani S, McCarthy A, McCarthy G, McInnis D, McLean S, McLean A, Monier D, Montreuil S, Neal L, Newman S, O'Keefe D, Oprici T, Otis J, Ouellet G, Parmar M, Paul M, Petrella R, Petrella S, Phillips R, Poisson D, Prieur S, Rabasa-Lhoret R, Rajakumar G, Rajakumar A, Raymond J, Richard D, Rideout G, Robert C, Robitaille Y, Ross D, Ross S, Rowe R, Salmon C, Saunier D, Savard C, Savard D, Sayeed R, Sayeed Z, Sestier F, Shaban J, Shu D, Sigal R, Silverberg J, Smith E, Smith R, Soucy J, Starra R, Stearn B, Steel D, Steinson D, Sternberg B, Stewart D, Stone F, Sussex B, Tippe D, Toupin-Halle A, Trapsa D, Tremblay S, Troung N, van Buuren J, VanSickle L, Verdonk R, Whitsitt P, Wilson R, Winkler L, Wong W, Woo V, Wozniak P, Yale J, Zaniol D, Zaychkowsky L, Zimakas G, Zinman B, Zmijowskyj T, Lanas F, Altamirano MA, Murua FB, Landaeta O, Larenas G, Kiefer VR, Roddriguez L, Carrasco GT, Laakso M, Harkonen P, Hiltunen L, Jantunen A, Keinanen-Kiukaanniemi S, Laakso MM, Lahdensuo E, Rutanen J, Saastamoinen E, Salaspuro V, Sivenius K, Valle T, Hanefeld M, Budziarek P, Engeli S, Fache K, Fischer C, Flehmig K, Gordalla A, Gottschalk I, Habel M, Hampel R, Henkel E, Höltzl S, Jordan J, Kletetschka M, Kresse C, Lehmann D, Mehling H, Otte C, Pein M, Pfeffer B, Ploog B, Schaper F, Scholz G, Stoffels G, Strauss A, Wilhelm K, Balazs B, Balogh E, Birkus Z, Boros T, Gyarmati G, Hati K, Hermanyi Z, Herold M, Kempler P, Kohari A, Laszlo Z, Nagy F, Nemeth C, Poor F, Pusztai P, Sandor K, Simon K, Somogyi A, Takacs J, Toth A, Varga E, Voros P, Mohan V, Aravind S, Aravind SR, Ayyar V, Dharmalingam M, Ganapathi B, Gayatri R, Gopal U, Idiculla J, Kalaivani U, Karkuzhali K, Kavitha L, Krishnan S, Kumar P, Kumar K, Monika M, Muniswamy M, Devi MP, Pais P, Poongothai S, Prakash S, Ramu M, Rao PV, Rao C, Shailaja K, Sreenivas T, Sudha S, Udayakumar K, Yajnik C, Pirags V, Erina A, Gailiss E, Gara S, Gozite A, Hansone S, Kreislere I, Liepa L, Ozolina M, Putane L, Raibarts J, Rasa I, Rozkova N, Rudzite E, Staka A, Veze I, Arellano S, Bañuelos K, Calvo C, Carbajal M, Cardona E, Castaneda R, Chavira J, Dominguez C, Escalante M, Flores E, Gómez F, Gonzalez J, González-Barcena D, Granados C, Illescas J, Jimenez M, Mancillas L, Mejia L, Mendoza C, Mendoza L, Muñoz M, Muñoz A, Padilla V, Pascoe S, Plascencia O, Ramos C, Reza A, Rubio I, Ruiz E, Vidrio M, Alhakim M, Bemelmans V, de Backer W, Rooda SE, Guldemond F, Hulshof M, Jonker J, Koppeschaar H, Meinema K, Pondman-Mulder M, Ponteyn-Rose S, van Asten K, van de Walle V, van Kempen W, Bryne B, Enderle B, Furuseth K, Halse J, Henriksen T, Hertzenberg A, Faehn AH, Knudsrod O, Lerssl S, Loennicken C, Murud K, Steinbo E, Vaaler S, Baranowska A, Baranska M, Blaszak J, Bronisz M, Ceremuzynski L, Cywinska H, Czempik E, Gmytrasiewicz M, Grochola A, Grzegorz O, Ignaczak P, Janik K, Jankiewicz B, Kania G, Kawka-Urbanek T, Kolaczek M, Kopcik D, Kordys M, Krainska A, Majer J, Makuch M, Miekus P, Mormul J, Mrowczynska A, Nowak D, Nowakowski P, Ogorek M, Oleskowaska L, Paliszewska L, Przywoska-Para B, Pszonak S, Rozwodowska M, Rucinski M, Rzyman M, Sikora-Frac M, Stecka-Wierzbicka J, Swiatkowski M, Swierczynski R, Szczepanska A, Szpajer M, Ukleja-Adamowicz M, Urbaniak A, Winek D, Wojewoda P, Zaborksa B, Zadrosny J, Zak J, Zalska B, Fodor G, Bilicky M, Caprnda M, Dukat A, Dukat A, Gajdosova M, Lietava J, Penz P, Thurzo M, Vachulova A, Conget I, Hurtado EA, Armayor M, Bernardino J, Sien CC, Carrarro R, de Teresa Pareno L, Diez L, Esteban G, Lopez LF, Gabriel R, Herola AG, Girones C, Lamas LG, Hermosa G, Fernandez PL, Macia M, Morillejo DM, Puig J, Roldan C, Urioste LR, Carranza ES, Segura J, Serrano I, Tudelilla F, Anders M, Andrén L, Berndtson I, Dahlén G, Eriksson A, Escar M, Jungersten L, Lindh G, Nielsen H, Ny L, Polhem B, Sandberg M, Skrtic S, Svensson S, Wallerstedt S, Dinccag N, Kaya S, Oglagu Z, Tutuncu Y, Davies M, Barron J, Beaverstock J, Borthwick L, Bradford B, Bryan L, Capps N, Coates F, Dickson S, Donaldson D, Forbes F, Fox C, Hall K, Hollway M, Howe J, Jamieson J, MacLeod K, MacLeod M, Maiden J, Matthews D, McIntosh M, McQuaid S, Millward A, Nayani G, Neil A, Page M, Piper J, Ramell M, Reynolds T, Ross S, Shore A, Tonks L, White S, Wylie J, Probstfield J, Anderson S, Anteola E, Araghi A, Bahtyiar G, Baker S, Bakris G, Basta E, Bastien A, Bell D, Bergenstal R, Lopez LB, Bigger J, Brautigam D, Bultermeier N, Burgos-Calderon R, Cacia D, Casale M, Charles C, Chiarot J, Cipolle M, Coley L, Cushman B, de Lemos J, Deshmukh M, DeVivo L, Donovan D, Elliott W, Farag A, Flack J, Fuste P, Garay S, De La Rosa DG, De La Rosa RG, Getaneh A, Ginsberg H, Goland R, Goldberg R, Griffin S, Griffith L, Grimm R, Guber H, Serrano BG, Haddad G, Hagen M, Hall K, Hamrahian A, Herr D, Hoogwerf B, Izhar M, Joseph L, Kashyap S, Kelly M, Kempainen S, Khera A, Kringas M, Levin J, Linz P, List S, Lopez-Jimenez C, Los E, Manaiermam M, Margolis K, Matzinger M, McGill J, McGuire D, Caban GM, Mehta A, Merkle L, Meyer B, Monk A, Montalvo-Burke L, Nelson C, Neri G, Nicasio J, Octaviani C, Ovalle F, Padilla S, Pepper P, Portalatin O, Ramirez J, Rao Kashyap S, Riddle M, Cruz AR, Saavedra G, Scharf D, Seibold L, Shah S, Shay D, Siraj E, Slavik B, Smith M, Solomon S, Spencer J, Stephens E, Thomas L, Vasquez E, Ocasio WV, Vetrano M, Walsh S, Zimmerman R, Barr N, Choppick C, Desai D, George J, Khatib P, Killman K, MacRae L, MacRae S, Pasha F, Rangachari U, Reiding V, Robinson D, Santarelli L, Shannon J, Pascual A, Rovito C, Fricke B, McBride E, Richmond S, Smith P, Frenette L, Magi A, Montecinos A, Keenan J, Starrett J, Ramo J, Tarvainen M, Güth A, Weise B, Kumar V, Balode I, Zilgalve G, Garcia I, Liceaga P, Moreno A, Bratten G, Ronning I, Nowak W, West W, Margo B, Martinez O, Dahl G, Bookelmann Y, Schoonhoven M, Cetin Z, Clare S, Sackett DL, Altman D, Bennett P, Clark CM, Hamman R, Ryden L.

Abstract

OBJECTIVE:

Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) are risk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined the effects of ramipril and rosiglitazone on combined and individual CVD and renal outcomes in people with IGT and/or IFG in the Diabetes REduction Assessment With ramipril and rosiglitazone Medication (DREAM) trial.

RESEARCH DESIGN AND METHODS:

A total of 5,269 people aged >or=30 years, with IGT and/or IFG without known CVD or renal insufficiency, were randomized to 15 mg/day ramipril versus placebo and 8 mg/day rosiglitazone versus placebo. A composite cardiorenal outcome and its CVD and renal components were assessed during the 3-year follow-up.

RESULTS:

Compared with placebo, neither ramipril (15.7% [412 of 2,623] vs. 16.0% [424 of 2,646]; hazard ratio [HR] 0.98 [95% CI 0.84-1.13]; P = 0.75) nor rosiglitazone (15.0% [394 of 2,635] vs. 16.8% [442 of 2,634]; 0.87 [0.75-1.01]; P = 0.07) reduced the risk of the cardiorenal composite outcome. Ramipril had no impact on the CVD and renal components. Rosiglitazone increased heart failure (0.53 vs. 0.08%; HR 7.04 [95% CI 1.60-31.0]; P = 0.01) but reduced the risk of the renal component (0.80 [0.68-0.93]; P = 0.005); prevention of diabetes was independently associated with prevention of the renal component (P < 0.001).

CONCLUSIONS:

Ramipril did not alter the cardiorenal outcome or its components. Rosiglitazone, which reduced diabetes, also reduced the development of renal disease but not the cardiorenal outcome and increased the risk of heart failure.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00095654.

PMID:
18268075
DOI:
10.2337/dc07-1868
[PubMed - indexed for MEDLINE]
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