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/Title (Approche multirisque du patient diabetique de type 2: desaccord sur les valeurs cibles suite a l'etude ACCORD.)
/Subject (The ACCORD trial investigated the effects of intensifying the global management of 10,251 type 2 diabetic patients, with established cardiovascular disease or at least two other cardiovascular risk factors, on a composite endpoint \(non fatal myocardial infarction, stroke and cardiovascular death\). The attempt to reduce HbA1c level below 6% was associated with an increased cardiovascular mortality \(despite a reduction in non fatal myocardial infarcts\); lowering systolic blood pressure below 120 mmHg instead of 140 mmHg did not provide any additional benefit; finally, the control of atherogenic dyslipidaemia, with fenofibrate added to a statin, did not modify the composite endpoint \(despite a positive effect in the subgroup of patients with high triglycerides and low HDL cholesterol\). These rather disappointing results should be interpreted to provide practical guidelines.)
/Keywords (Blood Pressure; Cardiovascular Diseases/prevention & control; Clinical Trials as Topic; Diabetes Mellitus, Type 2/blood/drug therapy; Hemoglobin A, Glycosylated/analysis; Humans; Hypoglycemic Agents/therapeutic use; Lipids/blood)
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Microsoft Word - Rev Med Suisse 2010 ACCORD
Monique Marchand
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