Division of Cardiology, University of Texas Health Science Center, San Antonio, TX, USA.
Division of Endocrinology, Diabetes and Metabolism, Ohio State University, Columbus, OH, USA.
Prim Care Diabetes. 2020 Jun;14(3):193-212. doi: 10.1016/j.pcd.2019.09.008. Epub 2019 Nov 6.
Cardiovascular disease (CVD) is the primary cause of morbidity and mortality in patients with type 2 diabetes (T2D). This review examines the impact of cardiovascular outcome trials (CVOTs) on clinical practice. To date, all CVOTs have shown non-inferiority versus placebo (both added to standard of care) against a primary endpoint of 3- or 4-point major adverse cardiovascular event (MACE), confirming CV safety of these treatments. Additionally, some CVOTs have shown superiority to placebo against the same MACE endpoint, suggesting a cardioprotective action for these treatments. This is reflected in guideline updates, which primary care physicians should consider when personalizing treatments.
心血管疾病 (CVD) 是 2 型糖尿病 (T2D) 患者发病率和死亡率的主要原因。本综述探讨了心血管结局试验 (CVOT) 对临床实践的影响。迄今为止，所有 CVOT 均显示与安慰剂（均添加至标准治疗）相比在 3 或 4 点主要不良心血管事件 (MACE) 主要终点方面非劣效性，证实了这些治疗方法的心血管安全性。此外，一些 CVOT 显示与安慰剂相比在相同的 MACE 终点上具有优越性，提示这些治疗方法具有心脏保护作用。这反映在指南更新中，初级保健医生在个性化治疗时应考虑这些更新。
