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Rev Med Suisse. 2010 Sep 1;6(260):1582-7.

[Multirisk approach of the type 2 diabetic patient: controversies surrounding target values after the ACCORD trial].

[Article in French]

Author information

1
Service de diabétologie, nutrition et maladies métaboliques et Unité de pharmacologie clinique, Département de médecine, CHU Sart Tilman, 4000 Liege, Belgique. andre.scheen@chu.ulg.ac.be

Abstract

The ACCORD trial investigated the effects of intensifying the global management of 10,251 type 2 diabetic patients, with established cardiovascular disease or at least two other cardiovascular risk factors, on a composite endpoint (non fatal myocardial infarction, stroke and cardiovascular death). The attempt to reduce HbA1c level below 6% was associated with an increased cardiovascular mortality (despite a reduction in non fatal myocardial infarcts); lowering systolic blood pressure below 120 mmHg instead of 140 mmHg did not provide any additional benefit; finally, the control of atherogenic dyslipidaemia, with fenofibrate added to a statin, did not modify the composite endpoint (despite a positive effect in the subgroup of patients with high triglycerides and low HDL cholesterol). These rather disappointing results should be interpreted to provide practical guidelines.

PMID:
20853712
[Indexed for MEDLINE]
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