PMID- 27236108
OWN - NLM
STAT- MEDLINE
DCOM- 20170804
LR  - 20170910
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 218
DP  - 2016 Sep 1
TI  - Effects of intensive glucose lowering in treatment of type 2 diabetes mellitus on 
      cardiovascular outcomes: A meta-analysis of data from 58,160 patients in 13 
      randomized controlled trials.
PG  - 50-58
LID - S0167-5273(16)30869-5 [pii]
LID - 10.1016/j.ijcard.2016.04.163 [doi]
AB  - BACKGROUND: Previous trials indicated that intensive glucose lowering in 
      treatment of patients with type 2 diabetes mellitus (T2DM) was associated with a 
      higher incidence of mortality. We therefore conducted a meta-analysis to evaluate 
      the benefits and harms of intensive glucose lowering therapy in treatment of T2DM 
      patients on major cardiovascular outcomes. METHODS: Randomized controlled trials 
      (RCTs) were obtained from searches of PubMed, EmBase, and the Cochrane Library 
      electronic databases until Feb. 2016. Relative risk (RR) was used to measure the 
      treatment effect by random-effect model. Meta-regression, sensitivity analyses, 
      subgroup analyses, and publication biases were also conducted. RESULTS: Thirteen 
      RCTs were included with 58,160 T2DM patients and reported 5719 major 
      cardiovascular events (MACEs), 6569 deaths, 2057 cardiac death cases, 3201 
      myocardial infarction (MI) cases, 1835 stroke cases, and 1778 congestive heart 
      failure cases. Intensive glucose lowering therapy significantly reduced risk of 
      MACEs (RR: 0.92; 95%CI: 0.85-1.00; P=0.042), and MI (RR: 0.90; 95%CI: 0.82-0.98; 
      P=0.020) compared with conventional glucose control therapy. Furthermore, 
      intensive glucose lowering therapy has no significant effect on the incidence of 
      total mortality (RR: 0.98; 95%CI: 0.91-1.07; P=0.693), cardiac death (RR: 1.00; 
      95%CI: 0.87-1.04; P=0.999), stroke (RR: 0.94; 95%CI: 0.84-1.06; P=0.333), and 
      congestive heart failure (RR: 1.19; 95%CI: 0.96-1.48; P=0.108). CONCLUSION: T2DM 
      patients who received intensive glucose lowering therapy are associated with a 
      reduced risk of MACEs and MI, whereas it has no significant effect on the risk of 
      total mortality, cardiac death, stroke, and congestive heart failure. These 
      effects might differ when stratified by baseline characteristics in T2DM 
      patients.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Fang, Hong-Juan
AU  - Fang HJ
AD  - Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical 
      University, Beijing 100050, China.
FAU - Zhou, Yu-Hao
AU  - Zhou YH
AD  - Department of Rehabilitation Institute, Shanghai Seventh People's Hospital, 
      Shanghai 200137, China.
FAU - Tian, Yong-Ji
AU  - Tian YJ
AD  - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 
      6 Tiantan Xili, Dongcheng District, Beijing 100050, China.
FAU - Du, Han-Yang
AU  - Du HY
AD  - Department of Emergency, Beijing Tiantan Hospital, Capital Medical University, 6 
      Tiantan Xili, Dongcheng District, Beijing 100050, China.
FAU - Sun, Yan-Xia
AU  - Sun YX
AD  - Department of Anesthesiolgy, Beijing TongRen Hospital, Capital Medical 
      University, No.2 Chongwenmennei Street, Dongcheng District, Beijing 100730, 
      China.
FAU - Zhong, Li-Yong
AU  - Zhong LY
AD  - Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical 
      University, Beijing 100050, China. Electronic address: zhongliyong@126.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20160513
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Blood Glucose/drug effects/*metabolism
MH  - Cardiovascular Diseases/*blood/*drug therapy/epidemiology
MH  - Diabetes Mellitus, Type 2/*blood/*drug therapy
MH  - Humans
MH  - Hypoglycemic Agents/pharmacology/therapeutic use
MH  - Randomized Controlled Trials as Topic/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cardiovascular
OT  - Intensive glucose lowering
OT  - Meta-analysis
OT  - Type 2 diabetes mellitus
EDAT- 2016/05/29 06:00
MHDA- 2017/08/05 06:00
CRDT- 2016/05/29 06:00
PHST- 2016/04/08 00:00 [received]
PHST- 2016/04/29 00:00 [accepted]
PHST- 2016/05/29 06:00 [entrez]
PHST- 2016/05/29 06:00 [pubmed]
PHST- 2017/08/05 06:00 [medline]
AID - S0167-5273(16)30869-5 [pii]
AID - 10.1016/j.ijcard.2016.04.163 [doi]
PST - ppublish
SO  - Int J Cardiol. 2016 Sep 1;218:50-58. doi: 10.1016/j.ijcard.2016.04.163. Epub 2016 
      May 13.