University of Pittsburgh, GSPH, A530 Crabtree Hall, Pittsburgh, PA 15261, USA.
Am Heart J. 2008 Sep;156(3):528-536, 536.e1-5. doi: 10.1016/j.ahj.2008.05.015. Epub 2008 Jul 31.
The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial was undertaken to determine whether early revascularization intervention is superior to deferred intervention in the presence of aggressive medical therapy and whether antidiabetes regimens targeting insulin sensitivity are more or less effective than regimens targeting insulin provision in reducing cardiovascular events among patients with type 2 diabetes mellitus and stable coronary artery disease (CAD).
The BARI 2D trial is a National Institutes of Health-sponsored randomized clinical trial with a 2 x 2 factorial design. Between 2001 and 2005, 49 clinical sites in North America, South America, and Europe randomized 2,368 patients. At baseline, the trial collected data on clinical history, symptoms, and medications along with centralized evaluations of angiograms, electrocardiograms, and blood and urine specimens.
Most of the BARI 2D patients were referred from the cardiac catheterization laboratory (54%) or cardiology clinic (27%). Of the randomized participants, 30% were women, 34% were minorities, 61% had angina, and 67% had multiregion CAD. Moreover, 29% had been treated with insulin, 58% had hemoglobin A(1c) >7.0%, 41% had low-density lipoprotein cholesterol >or=100 mg/dL, 52% had blood pressure >130/80 mm Hg, and 56% had body mass index >or=30 kg/m(2).
Baseline characteristics in BARI 2D are well balanced between the randomized treatment groups, and the clinical profile of the study cohort is representative of the target population. As a result, the BARI 2D clinical trial is in an excellent position to evaluate alternative treatment approaches for diabetes and CAD.
糖尿病患者旁路血管成形术血运重建研究2(BARI 2D)试验旨在确定在积极药物治疗的情况下,早期血运重建干预是否优于延迟干预,以及在2型糖尿病合并稳定冠状动脉疾病(CAD)患者中,针对胰岛素敏感性的抗糖尿病治疗方案在降低心血管事件方面是否比针对胰岛素分泌的方案更有效或效果更差。
BARI 2D试验是一项由美国国立卫生研究院资助的随机临床试验,采用2×2析因设计。2001年至2005年期间,北美、南美和欧洲的49个临床地点将2368例患者随机分组。在基线时,该试验收集了临床病史、症状和用药数据,以及血管造影、心电图、血液和尿液标本的集中评估数据。
BARI 2D试验中的大多数患者来自心导管实验室(54%)或心脏病诊所(27%)。在随机参与者中,30%为女性,34%为少数族裔,61%有心绞痛,67%有多区域CAD。此外,29%曾接受胰岛素治疗,58%的糖化血红蛋白A1c>7.0%,41%的低密度脂蛋白胆固醇≥100mg/dL,52%的血压>130/80mmHg,56%的体重指数≥30kg/m²。
BARI 2D试验中随机治疗组之间的基线特征平衡良好,研究队列的临床特征代表了目标人群。因此,BARI 2D临床试验非常适合评估糖尿病和CAD的替代治疗方法。