Abstract | BACKGROUND: METHODS: Two investigators independently searched PubMed, the Cochrane CENTRAL register of controlled trials, metaRegister, pre-MEDLINE, and CINAHL from January 1970 to October 2010 for prospective controlled randomized trials comparing a more intensive glucose-lowering regimen to a standard regimen. The outcome of interest was HF-related events (both fatal and nonfatal). Odds ratios ( ORs) were calculated from published data from relevant trials and pooled with a random-effects meta-analysis. RESULTS: A total of 37,229 patients from 8 randomized trials were included in the analysis. Follow-up ranged from 2.3 to 10.1 years, and the overall number of HF-related events was 1469 (55% in the intensive treatment arm). The mean difference in glycated hemoglobin level between patients given standard treatment and those allocated to a more intensive regimen was 0.9%. Overall, the risk of HF-related events did not differ significantly between intensive glycemic control and standard treatment (OR 1.20, 95% CI 0.96-1.48), but the effect estimate was highly heterogeneous (I(2) = 69%). At subgroup analysis, intensive glycemic control achieved with high thiazolidinediones use significantly increased HF risk (OR 1.33, 95% CI 1.02-1.72). CONCLUSIONS:
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Authors | Davide Castagno, Jonathan Baird-Gunning, Pardeep S Jhund, Giuseppe Biondi-Zoccai, Michael R MacDonald, Mark C Petrie, Fiorenzo Gaita, John J V McMurray |
Journal | American heart journal
(Am Heart J)
Vol. 162
Issue 5
Pg. 938-948.e2
(Nov 2011)
ISSN: 1097-6744 [Electronic] United States |
PMID | 22093212
(Publication Type: Journal Article, Meta-Analysis)
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Copyright | Copyright © 2011 Mosby, Inc. All rights reserved. |
Chemical References |
- Hypoglycemic Agents
- Thiazolidinediones
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Topics |
- Aged
- Diabetes Mellitus, Type 2
(complications, drug therapy)
- Female
- Heart Failure
(complications)
- Humans
- Hypoglycemic Agents
(adverse effects, therapeutic use)
- Male
- Middle Aged
- Randomized Controlled Trials as Topic
- Risk Factors
- Thiazolidinediones
(adverse effects, therapeutic use)
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