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HEART2D
Hyperglycemia and its Effect after Acute Myocardial infarction on cardiovascular outcomes in patients with Type 2 Diabetes mellitus
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Author(s) |
(a) Milicevic Z, Raz I, Strojek K, Skrha J, Tan MH, Wyatt JW, Beattie SD, Robbins DC
(b) Raz I, Wilson PWF, Strojek K, Kowalska I, Bozikov V, Gitt AK, Jermendy G, Campaigne BN, Kerr L, Milicevic Z, Jacober SJ |
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Title(s) |
(a) Hyperglycemia and its effect after acute myocardial infarction on cardiovascular outcomes in patients with Type 2 diabetes mellitus (HEART2D). Study design
(b) Effects of prandial versus fasting glycemia on cardiovascular outcomes in type 2 diabetes: the HEART2D trial |
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Reference(s) |
(a) J Diabetes Complications 2005;19:80–7
(b) Diabetes Care 2009;32:381–6 |
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Disease |
AMI, diabetes mellitus |
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Purpose |
To compare the effects of two glucose-lowering strategies on cardiovascular outcomes in patients with diabetes mellitus after AMI |
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Study design |
Randomised, open, parallel-group |
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Follow-up |
Mean 2.7 years |
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Patients |
1115 patients (557 prandial strategy, 558 basal strategy), aged 30–75 years, with type 2 diabetes within 18 days of AMI
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Treatment regimen |
Insulin lispro before each meal, plus NPH insulin at bedtime if needed, to target postprandial blood glucose < 7.5 mmol/l (prandial strategy), or NPH insulin bid or insulin glargine once daily, to target fasting and preprandial blood glucose < 6.7 mmol/l (basal strategy) |
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Concomitant therapy |
Optimal treatment for major cardiovascular risk factors |
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Results |
The composite primary endpoint of cardiovascular death, nonfatal MI, nonfatal stroke, coronary revascularisation or hospitalisation for acute coronary syndrome occurred at similar rates in the prandial strategy group and the basal strategy group (31.2% vs 32.4%, hazard ratio 0.98, 95% CI 0.8–1.21) |
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Comments |
The trial was stopped early because of lack of efficacy of the prandial strategy |
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