International variation in outcomes among people with cardiovascular disease or cardiovascular risk factors and impaired glucose tolerance: Insights from the NAVIGATOR trial
Journal article
Dos Santos, Marilia Harumi Higuchi, Sharma, Abhinav, Sun, Jie Lena, Pieper, Karen, McMurray, John J.V., Holman, Rury R. and Lopes, Renato D.. (2017). International variation in outcomes among people with cardiovascular disease or cardiovascular risk factors and impaired glucose tolerance: Insights from the NAVIGATOR trial. Journal of the American Heart Association. 6(1), pp. 1 - 11. https://doi.org/10.1161/JAHA.116.003892
Authors | Dos Santos, Marilia Harumi Higuchi, Sharma, Abhinav, Sun, Jie Lena, Pieper, Karen, McMurray, John J.V., Holman, Rury R. and Lopes, Renato D. |
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Abstract | Background-—Regional differences in risk of diabetes mellitus and cardiovascular outcomes in people with impaired glucose tolerance are poorly characterized. Our objective was to evaluate regional variation in risk of new-onset diabetes mellitus, cardiovascular outcomes, and treatment effects in participants from the NAVIGATOR (Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research) trial. Methods and Results-—NAVIGATOR randomized people with impaired glucose tolerance and cardiovascular risk factors or with established cardiovascular disease to valsartan (or placebo) and to nateglinide (or placebo) with a median 5-year follow-up. Data from the 9306 participants were categorized by 5 regions: Asia (n=552); Europe (n=4909); Latin America (n=1406); North America (n=2146); and Australia, New Zealand, and South Africa (n=293). Analyzed outcomes included new-onset diabetes mellitus; cardiovascular death; a composite cardiovascular outcome of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke; and treatment effects of valsartan and nateglinide. Respective unadjusted 5-year risks for new-onset diabetes mellitus, cardiovascular death, and the composite cardiovascular outcome were 33%, 0.4%, and 4% for Asia; 34%, 2%, and 6% for Europe; 37%, 4%, and 8% for Latin America; 38%, 2%, and 6% for North America; and 32%, 4%, and 8% for Australia, New Zealand, and South Africa. After adjustment, compared with North America, European participants had a lower risk of new-onset diabetes mellitus (hazard ratio 0.86, 95% CI 0.78–0.94; P=0.001), whereas Latin American participants had a higher risk of cardiovascular death (hazard ratio 2.68, 95% CI 1.82–3.96; P |
Keywords | cardiovascular disease; diabetes mellitus; risk factor |
Year | 2017 |
Journal | Journal of the American Heart Association |
Journal citation | 6 (1), pp. 1 - 11 |
Publisher | John Wiley & Sons, Inc. |
ISSN | 2047-9980 |
Digital Object Identifier (DOI) | https://doi.org/10.1161/JAHA.116.003892 |
Scopus EID | 2-s2.0-85009961979 |
Open access | Open access |
Page range | 1 - 11 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version | |
Additional information | © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative |
Place of publication | United States |
https://acuresearchbank.acu.edu.au/item/89w81/international-variation-in-outcomes-among-people-with-cardiovascular-disease-or-cardiovascular-risk-factors-and-impaired-glucose-tolerance-insights-from-the-navigator-trial
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