| Title |
Reduced risk of heart failure with intensified multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: 21 years of follow-up in the randomised Steno-2 study
|
|---|---|
| Published in |
Diabetologia, May 2018
|
| DOI | 10.1007/s00125-018-4642-y |
| Pubmed ID | |
| Authors |
Jens Oellgaard, Peter Gæde, Peter Rossing, Rasmus Rørth, Lars Køber, Hans-Henrik Parving, Oluf Pedersen |
| Abstract |
In type 2 diabetes mellitus, heart failure is a frequent, potentially fatal and often forgotten complication. Glucose-lowering agents and adjuvant therapies modify the risk of heart failure. We recently reported that 7.8 years of intensified compared with conventional multifactorial intervention in individuals with type 2 diabetes and microalbuminuria in the Steno-2 study reduced the risk of cardiovascular disease and prolonged life over 21.2 years of follow-up. In this post hoc analysis, we examine the impact of intensified multifactorial intervention on the risk of hospitalisation for heart failure. One hundred and sixty individuals were randomised to conventional or intensified multifactorial intervention, using sealed envelopes. The trial was conducted using the Prospective, Randomised, Open, Blinded Endpoints (PROBE) design. After 7.8 years, all individuals were offered intensified therapy and the study continued as an observational follow-up study for an additional 13.4 years. Heart-failure hospitalisations were adjudicated from patient records by an external expert committee blinded for treatment allocation. Event rates were compared using a Cox regression model adjusted for age and sex. Eighty patients were assigned to each treatment group. Ten patients undergoing intensive therapy vs 24 undergoing conventional therapy were hospitalised for heart failure during follow-up. The HR (95% CI) was 0.30 (0.14, 0.64), p = 0.002 in the intensive-therapy group compared with the conventional-therapy group. Including death in the endpoint did not lead to an alternate overall outcome; HR 0.51 (0.34, 0.76), p = 0.001. In a pooled cohort analysis, an increase in plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) during the first two years of the trial was associated with incident heart failure. Intensified, multifactorial intervention for 7.8 years in type 2 diabetic individuals with microalbuminuria reduced the risk of hospitalisation for heart failure by 70% during a total of 21.2 years of observation. ClinicalTrials.gov NCT00320008. |
X Demographics
The data shown below were collected from the profiles of 73 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 14 | 19% |
| United Kingdom | 5 | 7% |
| France | 2 | 3% |
| Brazil | 2 | 3% |
| Venezuela, Bolivarian Republic of | 2 | 3% |
| Japan | 2 | 3% |
| Denmark | 2 | 3% |
| India | 2 | 3% |
| Argentina | 1 | 1% |
| Other | 9 | 12% |
| Unknown | 32 | 44% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 54 | 74% |
| Practitioners (doctors, other healthcare professionals) | 10 | 14% |
| Scientists | 6 | 8% |
| Science communicators (journalists, bloggers, editors) | 3 | 4% |
Mendeley readers
The data shown below were compiled from readership statistics for 114 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 114 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 12 | 11% |
| Student > Bachelor | 12 | 11% |
| Researcher | 10 | 9% |
| Other | 6 | 5% |
| Student > Postgraduate | 6 | 5% |
| Other | 23 | 20% |
| Unknown | 45 | 39% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 43 | 38% |
| Nursing and Health Professions | 8 | 7% |
| Biochemistry, Genetics and Molecular Biology | 5 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 4% |
| Computer Science | 2 | 2% |
| Other | 3 | 3% |
| Unknown | 49 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 59. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 September 2018.
All research outputs
#688,272
of 24,602,766 outputs
Outputs from Diabetologia
#370
of 5,282 outputs
Outputs of similar age
#15,729
of 336,296 outputs
Outputs of similar age from Diabetologia
#13
of 61 outputs
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