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Scoring System to Optimize Pioglitazone Therapy After Stroke Based on Fracture Risk.
Viscoli, Catherine M; Kent, David M; Conwit, Robin; Dearborn, Jennifer L; Furie, Karen L; Gorman, Mark; Guarino, Peter D; Inzucchi, Silvio E; Stuart, Amber; Young, Lawrence H; Kernan, Walter N.
Afiliación
  • Viscoli CM; From the Department of Internal Medicine, General Medicine (C.M.V., W.N.K.), Yale University School of Medicine, New Haven, CT.
  • Kent DM; Predictive Analytics and Comparative Effectiveness (PACE) Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston MA (D.M.K.).
  • Conwit R; National Institute of Neurological Disorders and Stroke, Bethesda, MD (R.C.).
  • Dearborn JL; Department of Neurology, Vascular Neurology (J.L.D.), Yale University School of Medicine, New Haven, CT.
  • Furie KL; Department of Neurology, Alpert Medical School of Brown University, Providence, RI (K.L.F.).
  • Gorman M; Department of Neurology, Maine Medical Group, Portland, ME (M.G.).
  • Guarino PD; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA (P.D.G.).
  • Inzucchi SE; Department of Internal Medicine, Endocrinology (S.E.I.), Yale University School of Medicine, New Haven, CT.
  • Stuart A; University of Connecticut School of Medicine, Farmington, CT (A.S.).
  • Young LH; Department of Internal Medicine, Cardiology (L.H.Y.), Yale University School of Medicine, New Haven, CT.
  • Kernan WN; From the Department of Internal Medicine, General Medicine (C.M.V., W.N.K.), Yale University School of Medicine, New Haven, CT.
Stroke ; 50(1): 95-100, 2019 Jan.
Article en En | MEDLINE | ID: mdl-30580725
Background and Purpose- The insulin sensitizer, pioglitazone, reduces cardiovascular risk in patients after an ischemic stroke or transient ischemic attack but increases bone fracture risk. We conducted a secondary analysis of the IRIS trial (Insulin Resistance Intervention After Stroke) to assess the effect of pretreatment risk for fracture on the net benefits of pioglitazone therapy. Methods- IRIS was a randomized placebo-controlled trial of pioglitazone that enrolled patients with insulin resistance but without diabetes mellitus within 180 days of an ischemic stroke or transient ischemic attack. Participants were recruited at 179 international centers from February 2005 to January 2013 and followed for a median of 4.8 years. Fracture risk models were developed from patient characteristics at entry. Within fracture risk strata, we quantified the effects of pioglitazone compared with placebo by estimating the relative risks and absolute 5-year risk differences for fracture and stroke or myocardial infarction. Results- The fracture risk model included points for age, race-ethnicity, sex, body mass index, disability, and medications. The relative increment in fracture risk with pioglitazone was similar in the lower (
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Stroke Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Stroke Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos