1. n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia
- Author
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David Clayton, Robert Cuddihy, Jose Antônio Marin-Neto, Jeanne Clark, Esra Hatipoglu, Mohd Shazli Draman, Alfredo Ramirez, Philip Böhme, Victor Gurevich, Miguel Urina, Angel L. Fernández, Maja Cigrovski Berkovic, Valdis Pirags, Evgeny Shkolnik, Alexander Vonbank, Salim Yusuf, Heather Lochnan, Jan Cornel, Bu Yeap, Tatiana Adasheva, Giuseppe Derosa, Aldo Pietro Maggioni, ALVARO AVEZUM, Igor Bondarenko, Monica Acevedo, Francesco Cacciatore, A.S. Ametov, Weiping Jia, Iana Orlova, Anders Waldenström, B. L. Gregoire Nyomba, Neslihan Bascil Tutuncu, Tristan Richardson, Anastasia F Hutchinson, Vladimir Zadionchenko, Sudeep K, Moti Kashyap, Adrian Vlad, Aivars Lejnieks, Jeong-Taek Woo, Fernando Lanas, Nicolae Hancu, Kurt Boman, Cristina Facanha, Laura Bryan, Louise Bordeleau, Patricio Lopez-Jaramillo, Adriana Forti, Flavia Lucia Lombardo, Gunnar Gislason, Malgorzata Sikora-Frac, Peter Colman, Veronique Kerlan, Olga Bulkina, Melanie Davies, Maira Marino, JAIME CARMONA-HUERTA, Hertzel Gerstein, Jackie Bosch, Carlos Morillo, Alina Babenko, Philip Aylward, SONIA GAZTAMBIDE, Yury Vasyuk, Asem Ali, Ragnar Martin Joakimsen, Anna Novials, Andrzej Budaj, Anne Taylor, Department of General Surgery. Surgical Oncology Unit, Reina Sofía University Hospital, Population Health Research Institute, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service d'Endocrinologie (CHRU - Endocrino), and Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)
- Subjects
Male ,MESH: Treatment Failure ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Insulin Glargine ,030204 cardiovascular system & hematology ,MESH: Intention to Treat Analysis ,MESH: Proportional Hazards Models ,chemistry.chemical_compound ,0302 clinical medicine ,MESH: Cholesterol ,dysglycemia ,MESH: Fatty Acids, Omega-3 ,MESH: Double-Blind Method ,Treatment Failure ,030212 general & internal medicine ,MESH: Incidence ,MESH: Aged ,MESH: Middle Aged ,Dysglycemia ,cardiovascular events ,Incidence ,General Medicine ,MESH: Follow-Up Studies ,Middle Aged ,INFARTO DO MIOCÁRDIO ,Intention to Treat Analysis ,3. Good health ,Insulin, Long-Acting ,Cholesterol ,Cardiovascular Diseases ,n-3 fatty acid ,Cardiology ,Drug Therapy, Combination ,Female ,medicine.drug ,MESH: Diabetes Mellitus, Type 2 ,MESH: Triglycerides ,medicine.medical_specialty ,MACE diabetes glargin ,03 medical and health sciences ,Pharmacotherapy ,Double-Blind Method ,Internal medicine ,Diabetes mellitus ,MESH: Hypoglycemic Agents ,Fatty Acids, Omega-3 ,Glucose Intolerance ,medicine ,Humans ,Hypoglycemic Agents ,Triglycerides ,MESH: Glucose Intolerance ,Aged ,Proportional Hazards Models ,Intention-to-treat analysis ,MESH: Humans ,business.industry ,Insulin glargine ,Proportional hazards model ,Insulin ,MESH: Cardiovascular Diseases ,medicine.disease ,MESH: Male ,MESH: Drug Therapy, Combination ,Endocrinology ,Diabetes Mellitus, Type 2 ,chemistry ,Heart failure ,MESH: Insulin, Long-Acting ,business ,MESH: Female ,Follow-Up Studies - Abstract
International audience; BACKGROUND: The use of n-3 fatty acids may prevent cardiovascular events in patients with recent myocardial infarction or heart failure. Their effects in patients with (or at risk for) type 2 diabetes mellitus are unknown. METHODS: In this double-blind study with a 2-by-2 factorial design, we randomly assigned 12,536 patients who were at high risk for cardiovascular events and had impaired fasting glucose, impaired glucose tolerance, or diabetes to receive a 1-g capsule containing at least 900 mg (90% or more) of ethyl esters of n-3 fatty acids or placebo daily and to receive either insulin glargine or standard care. The primary outcome was death from cardiovascular causes. The results of the comparison between n-3 fatty acids and placebo are reported here. RESULTS: During a median follow up of 6.2 years, the incidence of the primary outcome was not significantly decreased among patients receiving n-3 fatty acids, as compared with those receiving placebo (574 patients [9.1%] vs. 581 patients [9.3%]; hazard ratio, 0.98; 95% confidence interval [CI], 0.87 to 1.10; P=0.72). The use of n-3 fatty acids also had no significant effect on the rates of major vascular events (1034 patients [16.5%] vs. 1017 patients [16.3%]; hazard ratio, 1.01; 95% CI, 0.93 to 1.10; P=0.81), death from any cause (951 [15.1%] vs. 964 [15.4%]; hazard ratio, 0.98; 95% CI, 0.89 to 1.07; P=0.63), or death from arrhythmia (288 [4.6%] vs. 259 [4.1%]; hazard ratio, 1.10; 95% CI, 0.93 to 1.30; P=0.26). Triglyceride levels were reduced by 14.5 mg per deciliter (0.16 mmol per liter) more among patients receiving n-3 fatty acids than among those receiving placebo (P
- Published
- 2012
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