A post-hoc analysis of the SPRINT trial finds a higher triglyceride-glucose index is associated with greater cardiovascular risk in controlled hypertension, significant only under standard blood pressure treatment. PICO summary and expert commentary.
Browsing: Cardiovascular
Cardiovascular outcomes, heart failure, cardio-renal protection, hypertension, and lipid-lowering trials in diabetes and endocrinology.
A 52-week open-label randomized trial found once-weekly semaglutide reduced LDL cholesterol and shifted lipoprotein subfractions toward a less atherogenic profile versus sitagliptin in obese type 2 diabetes. PICO summary and expert commentary.
A secondary lipidomic analysis of two randomized crossover feeding trials found that lowering dietary saturated fat reshaped the lipoprotein(a) lipidome while plasma Lp(a) rose. PICO summary and expert commentary.
A randomized trial in 112 veterans found that immediate return of confirmed familial hypercholesterolemia genetic results plus telegenetic counseling did not significantly reduce LDL-C versus delayed return. PICO summary and expert commentary.
CARDS demonstrated that atorvastatin 10 mg reduces major cardiovascular events by 37% and stroke by 48% in patients with type 2 diabetes and normal to mildly elevated LDL-cholesterol without prior CVD, confirming that cardiovascular risk rather than LDL level should determine statin initiation and establishing universal statin use in primary cardiovascular prevention for type 2 diabetes.
HPS demonstrated that simvastatin reduces major vascular events by 24% across all high-risk patients regardless of baseline LDL-cholesterol level, including those with diabetes without established coronary disease, eliminating the treatment threshold concept and establishing absolute cardiovascular risk as the primary criterion for statin therapy — one of the most influential results in preventive cardiology.
WOSCOPS demonstrated that pravastatin reduces the combined incidence of nonfatal MI and coronary death by 31% in men with hypercholesterolaemia and no prior MI, establishing the primary prevention indication for statin therapy and providing the first large randomised evidence for population-level lipid lowering in high-risk individuals without established cardiovascular disease.
The 4S trial demonstrated that simvastatin reduces all-cause mortality by 30%, coronary death by 42%, and major coronary events by 34% in patients with established coronary heart disease and no excess non-cardiovascular mortality, resolving the safety debate and establishing statin therapy as the standard of care in secondary cardiovascular prevention.
VADT demonstrated that intensive glucose control achieving a median HbA1c of 6.9% did not significantly reduce cardiovascular events or mortality in veterans with long-standing type 2 diabetes and high cardiovascular disease prevalence, completing the ACCORD/ADVANCE/VADT triptych that defined the limits of aggressive glycaemic management in advanced disease.
ADVANCE demonstrated that intensive glucose control targeting HbA1c below 6.5% using a gliclazide-based strategy reduces nephropathy by 21% and the microvascular composite by 14% in high-risk type 2 diabetes, without the mortality hazard observed in ACCORD, providing important context for how glycaemic targets and treatment strategies interact with safety outcomes.