Tag Archives: ACCORD

Anaemia was one of several problems chosen for a case-based discussion in a session on common non-cardiac co-morbidities. Dr Callum Chapman (West Middlesex University Hospital) presented the case of an elderly patient with known coeliac disease who had undergone transcatheter aortic valve implantation, which resulted in a paraprosthetic leak and impingement of the mitral valve. Unfortunately despite medical management of the leak she presented to the elderly care service in New York Heart Association (NYHA) Class III heart failure and was extremely oedematous. Blood tests revealed an iron deficiency anaemia and a reduced transferrin saturati

Lowering LDL-cholesterol: we need to do better It is essential that high-risk patients attain the recommended low-density lipoprotein (LDL)-cholesterol target. As reported at the first late-breaking session, the choice and dose of statin are key factors influencing LDL-cholesterol lowering. In a meta-analysis of the VOYAGER (Individual Patient Data Meta-analysis of Statin Therapy in At-risk Groups: Effects of Rosuvastatin, Atorvastatin and Simvastatin) database of 37 studies of high-intensity statins, 71% of patients treated with rosuvastatin 40 mg achieved at least 50% reduction in LDL-cholesterol levels, compared with 59% for atorvastatin 8

ACCORD/INVEST: do not aim for normal blood pressure in diabetes patients with CAD The results of two trials comparing intensive versus more conventional blood pressure lowering in patients with diabetes at high cardiovascular risk have suggested that intensive treatment is not necessary and may be harmful in this population. In the ACCORD BP (Action to Control Cardiovascular Risk in Diabetes – Blood Pressure) trial, while intensive blood pressure treatment did reduce the risk of stroke, it failed to reduce the overall risk of cardiovascular events in patients and was associated with an increase in adverse events due to antihypertensive ther

These findings are in line with those of the US ACCORD trial which was stopped early because of an increased risk of death in type 2 diabetes patients who underwent intensive blood glucose lowering compared with conventional therapy. In the new UK study, published recently in The Lancet (Lancet 2010;375:481–9), the lowest death and event rates were seen at an HbA1c level of 7.5%. The new data come from studying around 48,000 type 2 diabetes patients aged 50 or over who are included in the UK General Practice Research Database. These patients had either had their treatment intensified from oral monotherapy to combination therapy with oral bl

New data on intensive glucose lowering in type 2 diabetes The results of three large trials investigating the clinical effects of intensive glucose lowering in patients with type II diabetes were presented at the recent American Diabetes Association meeting in San Francisco, USA, and have shown somewhat conflicting results. The ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial was stopped earlier this year because of an increased mortality in the intensive glucose lowering group. The two other trials – ADVANCE (Action in Diabetes and Vascular Disease – Preterax and Diamicron MR Controlled Evaluation) and VADT (Veteran’s A