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Diabetes and cardiovascular events in high-risk patients: Insights from a multicenter registry in a middle-income country.
Schaan, Beatriz D; de Figueiredo Neto, Jose Albuquerque; Moreira, Leila Beltrami; Ledur, Priscila; Mattos, Luiz Alberto P; Magnoni, Daniel; Precoma, Dalton Bertolim; Machado, Carlos Alberto; da Silva Brasileiro, Antônio Luiz; Pena, Felipe Montes; Harzheim, Erno; Montenegro, Sérgio; Bernardez-Pereira, Sabrina; Damiani, Lucas P; Consolim-Colombo, Fernanda M; de Paola, Angelo Amato Vicenzo; Andrade, Jadelson; Guimarães, Jorge Ilha; Berwanger, Otávio.
Afiliación
  • Schaan BD; Endocrine Division, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: bschaan@hcpa.edu.br.
  • de Figueiredo Neto JA; Universidade Federal do Maranhão, Maranhão, Brazil.
  • Moreira LB; Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
  • Ledur P; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Mattos LAP; Brazilian Society of Cardiology, Brazil.
  • Magnoni D; Hospital Dante Pazzanese, São Paulo, Brazil.
  • Precoma DB; Sociedade Hospitalar Angelina Caron, Paraná, Brazil.
  • Machado CA; Ambulatorio de Especialidades Maria Zelia, São Paulo, Brazil.
  • da Silva Brasileiro AL; Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
  • Pena FM; Hospital Escola Alvaro Alvim, Rio de Janeiro, Brazil.
  • Harzheim E; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
  • Montenegro S; Hospital Português, Pernambuco, Brazil.
  • Bernardez-Pereira S; Research Institute of Heart Hospital (Hcor), São Paulo, Brazil.
  • Damiani LP; Research Institute of Heart Hospital (Hcor), São Paulo, Brazil.
  • Consolim-Colombo FM; Brazilian Society of Cardiology, Brazil; Heart Institute of University of São Paulo, Brazil; Universidade Nove de Julho (UNINOVE), São Paulo, Brazil.
  • de Paola AAV; Brazilian Society of Cardiology, Brazil.
  • Andrade J; Brazilian Society of Cardiology, Brazil; Hospital da Bahia, Bahia, Brazil.
  • Guimarães JI; Brazilian Society of Cardiology, Brazil.
  • Berwanger O; Research Institute of Heart Hospital (Hcor), São Paulo, Brazil.
Diabetes Res Clin Pract ; 127: 275-284, 2017 May.
Article en En | MEDLINE | ID: mdl-28412543
AIMS: The aim of this study was to determine the rate of major clinical events and its determinants in patients with previous cardiovascular event or not, and with or without diabetes from a middle-income country. METHODS: REACT study is a multicenter registry conducted between July 2010 and May 2013 in Brazil. Patients were eligible if they were over 45years old and high cardiovascular risk. Patients were followed for 12months; data were collected regarding adherence to evidence-based therapies and occurrence of clinical events (all-cause mortality, non-fatal cardiac arrest, myocardial infarction, or stroke). RESULTS: A total of 5006 subjects was included and analyzed in four groups: No diabetes and no previous cardiovascular event, n=430; diabetes and no previous cardiovascular event, n=1138; no diabetes and previous cardiovascular event, n=1747; and diabetes and previous cardiovascular event, n=1691. Major clinical events in one-year follow-up occurred in 332 patients. A previous cardiovascular event was associated with a higher risk of having another event in the follow-up (HR 2.31 95% CI 1.74-3.05, p<0.001), as did the presence of diabetes (HR 1.28 95% CI 1.10-1.73, p=0.005). In patients with diabetes,failure to reach HbA1c targetswas related topoorer event-free survival compared to patients with good metabolic control (HR 1.70 95% CI 1.01-2.84, p=0.044). CONCLUSIONS: In Brazil, diabetes confers high risk for major clinical events, but this condition is not equivalent to having a previous cardiovascular event. Moreover, not so strict targets for HbA1c in patients with diabetes and previous cardiovascular events might be considered.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Diabetes Mellitus Tipo 2 Tipo de estudio: Clinical_trials / Etiology_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: Diabetes Res Clin Pract Asunto de la revista: ENDOCRINOLOGIA Año: 2017 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Diabetes Mellitus Tipo 2 Tipo de estudio: Clinical_trials / Etiology_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: Diabetes Res Clin Pract Asunto de la revista: ENDOCRINOLOGIA Año: 2017 Tipo del documento: Article Pais de publicación: Irlanda