Importance of cardiovascular disease risk management in patients with type 2 diabetes mellitus

Figures & data

Table 1 Trials and titles

Trial	Title	Registration (if available)
ACCEPT-D	Aspirin and simvastatin combination for cardiovascular events prevention trial in diabetes	ISRCTN48110081
ACCOMPLISH	Avoiding cardiovascular events through combination therapy in patients living with systolic hypertension	NCT00170950
ACCORD	Action to control cardiovascular risk in diabetes	NCT00000620
ACE	Acarbose cardiovascular evaluation trial	NCT00829660
ADVANCE	Action in diabetes and vascular disease: Preterax and Diamicron – modified release controlled evaluation	NCT00145925
AleCardio	A study with aleglitazar in patients with a recent acute coronary syndrome and type 2 diabetes mellitus	NCT01042769
AlePrevent	A study of aleglitazar in patients with stable cardiovascular disease and glucose Abnormalities	NCT01715818
ALLHAT	Antihypertensive and lipid-lowering treatment to prevent heart attack trial	NCT00000542
ASCEND	A study of cardiovascular events in diabetes	NCT00135226
CANVAS	Canagliflozin cardiovascular assessment study	NCT01032629
CARMELINA	Cardiovascular and renal microvascular outcome study with linagliptin in patients with type 2 diabetes mellitus at high vascular risk	NCT01897532
CAROLINA	Cardiovascular outcome study of linagliptin versus glimepiride in patients with type 2 diabetes	NCT01243424
DCCT	Diabetes control and complications trial	NCT00360815
DECLARE-TIMI 58	Multicenter trial to evaluate the effect of dapagliflozin on the incidence of cardiovascular events	NCT01730534
EDIC	Epidemiology of diabetes interventions and complications	NCT00360893
ELIXA	Evaluation of cardiovascular outcomes in patients with type 2 diabetes after acute coronary syndrome during treatment with AVE 0010 (lixisenatide)	NCT01147250
EMPA-REG OUTCOME	Empagliflozin cardiovascular outcome event trial	NCT01131676
EXAMINE	Examination of cardiovascular outcomes with alogliptin versus standard of care in patients with type 2 diabetes mellitus and acute coronary syndrome	NCT00968708
EXSCEL	Exenatide study of cardiovascular event lowering trial	NCT01144338
GRAND 306	Study of tak-875 in adults with type 2 diabetes and cardiovascular disease or risk factors for cardiovascular disease	NCT01609582
LEADER	Liraglutide effect and action in diabetes: evaluation of cardiovascular outcome results – a long term evaluation	NCT01179048
Look AHEAD	Look AHEAD: action for health in diabetes	NCT00017953
MRFIT	Multiple risk factor intervention trial	NCT00000487
ONTARGET	Ongoing telmisartan alone and in combination with ramipril global endpoint trial	NCT00153101
ORIGIN	Outcome reduction with initial glargine intervention	NCT00069784
PLATO	The platelet inhibition and patient outcomes trial	NCT00391872
REWIND	Researching cardiovascular events with a weekly incretin in diabetes	NCT01394952
SAVOR-TIMI 53	Saxagliptin assessment of vascular outcomes recorded in patients with diabetes mellitus – thrombolysis in myocardial infarction 53 study	NCT01107886
Steno-2	Intensified multifactorial intervention in patients with type 2 diabetes and microalbuminuria	NCT00320008
SUSTAIN 6	Trial to evaluate cardiovascular and other long-term outcomes with semaglutide in subjects with type 2 diabetes	NCT01720446
TECOS	Trial evaluating cardiovascular outcomes with sitagliptin	NCT00790205
T-emerge 8	A study of taspoglutide in patients with inadequately controlled diabetes mellitus type 2 and cardiovascular disease	NCT01018173
TIDE	Thiazolidinedione intervention with vitamin D intervention study	NCT00879970
TOSCA IT	Thiazolidinediones or sulphonylureas and cardiovascular accidents intervention trial	NCT00700856
TRITON-TIMI 38	Trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel – thrombolysis in myocardial infarction	NCT00097591
UKPDS	United Kingdom prospective diabetes study
VADT	Veterans Affairs and diabetes trial	NCT00032487

Table 2 Cardiovascular outcomes trials in diabetes

Clinical Trial.gov ID	Drug	Trial short namea	Sample size	Start date
Sodium glucose cotransporter 2 (SGLT2) inhibitors
NCT01032629^Citation83	Canagliflozin	CANVAS	4,330	Dec 2009
NCT01131676	Empagliflozin	EMPA-REG OUTCOME	7,000	Jul 2010
NCT01730534	Dapagliflozin	DECLARE-TIMI 58	17,150	Apr 2013
NCT01986881	Ertugliflozin		3,900	Nov 2013
Dipeptidyl peptidase-4 (DPP-4) inhibitors
NCT00790205	Sitagliptin	TECOS	14,000	Dec 2008
NCT00968708^Citation80	Alogliptin	EXAMINE	5,380	Oct 2009b
NCT01107886^Citation81	Saxagliptin	SAVOR-TIMI 53	16,492	May 2010b
NCT01243424^Citation84	Linagliptin	CAROLINA	6,000	Oct 2010
NCT01703208	MK-3102		4,000	Oct 2012
NCT01897532	Linagliptin	CARMELINA	8,300	Jul 2013
Glucagon like peptide-1 (GLP-1) agonists
NCT01018173	Taspoglutide	T-emerge 8	2,118	Jan 2010c
NCT01147250	Lixisenatide	ELIXA	6,000	Jun 2010
NCT01144338	Exenatide	EXSCEL	14,000	Jun 2010
NCT01179048^Citation85	Liraglutide	LEADER	9,340	Aug 2010
NCT01394952	Dulaglutide	REWIND	9,622	Jul 2011
NCT01720446	Semaglutide	SUSTAIN 6	3,260	Feb 2013
NCT01455896	ITCA 650		2,000	Mar 2013
Others
NCT00700856^Citation86	Pioglitazone versus SU	TOSCA IT	3,371	Sep 2008
NCT00879970^Citation87	Rosiglitazone/pioglitazone	TIDE	1,332	May 2009c
NCT01042769^Citation88	Aleglitazar	AleCardio	7,228	Jan 2010c
NCT01715818	Aleglitazar	AlePrevent	1,999	Dec 2012c
NCT00069784^Citation89	Insulin glargine	ORIGIN	12,537	Aug 2003b
NCT01959529	Insulin degludec		7,500	Oct 2013
NCT00829660	Acarbose	ACE	7,500	Feb 2009
NCT01609582	Fasiglifam (TAK-875)	GRAND 306	5,000	Jun 2012

Notes:

a For full trial names see Table 1;

b completed;

c terminated.

Table 3 Recommended blood pressure targets

Issuing organization	Blood pressure target (mmHg)
American Diabetes Association^Citation25	<140/80 <130/80 may be appropriate for certain individuals, such as younger patients, if achievable without undue treatment burden
American Association of Clinical Endocrinologists^Citation26	∼130/80
European Society of Cardiology/European Association for the Study of Diabetes^Citation27	<140/85
European Society of Hypertension/European Society of Cardiology^Citation106	<140/85
International Diabetes Federation^Citation107	≤130/80 Revise target upward in elderly or if there is significant risk of postural hypotension and falls

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