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Effects of Ramipril and Rosiglitazone onudCardiovascular and Renal Outcomes inudPeople With Impaired Glucose Toleranceudor Impaired Fasting Glucose

机译:雷米普利和罗格列酮对 ud的影响心血管和肾脏结局糖耐量减退的人 ud或空腹血糖受损

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摘要

OBJECTIVE— Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) areudrisk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined theudeffects of ramipril and rosiglitazone on combined and individual CVD and renal outcomes inudpeople with IGT and/or IFG in the Diabetes REduction Assessment With ramipril and rosiglitazoneudMedication (DREAM) trial.udRESEARCH DESIGNANDMETHODS— A total of 5,269 people aged30 years, withudIGT and/or IFG without known CVD or renal insufficiency, were randomized to 15 mg/dayudramipril versus placebo and 8 mg/day rosiglitazone versus placebo. A composite cardiorenaludoutcome and its CVD and renal components were assessed during the 3-year follow-up.udRESULTS— Compared with placebo, neither ramipril (15.7% [412 of 2,623] vs. 16.0% [424udof 2,646]; hazard ratio [HR] 0.98 [95% CI 0.84 –1.13]; P0.75) nor rosiglitazone (15.0% [394udof 2,635] vs. 16.8% [442 of 2,634]; 0.87 [0.75–1.01]; P 0.07) reduced the risk of theudcardiorenal composite outcome. Ramipril had no impact on the CVD and renal components.udRosiglitazone increased heart failure (0.53 vs. 0.08%; HR 7.04 [95% CI 1.60 –31.0]; P 0.01)udbut reduced the risk of the renal component (0.80 [0.68–0.93]; P 0.005); prevention ofuddiabetes was independently associated with prevention of the renal component (P 0.001).udCONCLUSIONS— Ramipril did not alter the cardiorenal outcome or its components. Rosiglitazone,udwhich reduced diabetes, also reduced the development of renal disease but not theudcardiorenal outcome and increased the risk of heart failure.
机译:目的:糖耐量降低(IGT)和/或空腹血糖(IFG)降低是糖尿病,心血管疾病(CVD)和肾脏疾病的危险因素。我们在雷米普利和罗格列酮/ udMedication(DREAM)试验的糖尿病减少评估中确定了雷米普利和罗格列酮对患有IGT和/或IFG的IGD和/或IGG患者联合和个体CVD和肾脏结局的影响。 udRESEARCH DESIGNANDMETHODS —总计5,269 30岁,患有 udIGT和/或IFG且无已知CVD或肾功能不全的患者被随机分为15毫克/天 udramipril与安慰剂,以及8毫克/天罗格列酮与安慰剂。结果:与安慰剂相比,雷米普利均无统计学意义(15.7%[2,623的412] vs. 16.0%[424 udof 2,646];与安慰剂相比,两者均未评估)。危险比[HR] 0.98 [95%CI 0.84 –1.13]; P0.75)或罗格列酮(15.0%[394 udof 2,635]与16.8%[442 of 2,634]; 0.87 [0.75–1.01]; P 0.07)降低了心外膜综合预后的风险。雷米普利对心血管疾病和肾脏成分没有影响。罗格列酮增加了心力衰竭(0.53比0.08%; HR 7.04 [95%CI 1.60 –31.0]; P 0.01) ud但降低了肾脏成分的风险(0.80 [0.68] –0.93]; P 0.005);糖尿病的预防与肾脏成分的预防独立相关(P 0.001)。结论—雷米普利不会改变心肾预后或其成分。罗格列酮减少糖尿病,也减少了肾脏疾病的发展,但没有减少心脏/肾脏的预后,增加了心力衰竭的风险。

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    Trial Investigators DREAM;

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