Achieving lipid targets in adults with type 2 diabetes: the Stop Atherosclerosis in Native Diabetics Study.
Achieving lipid targets in adults with type 2 diabetes: the Stop Atherosclerosis in Native Diabetics Study.
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DOI：
10.1016/j.jacl.2010.07.007
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发表时间：
2010-09
影响因子：
4.4
通讯作者：
Howard WM
中科院分区：
文献类型：
--
作者：
Russell M;Silverman A;Fleg JL;Lee ET;Mete M;Weir M;Wilson C;Yeh F;Howard BV;Howard WM
Although lipid management in diabetes is standard practice, goals often are neither met nor maintained. Strategies for achieving lower targets have not been explored. The Stop Atherosclerosis in Native Diabetics Study (SANDS) randomized patients with diabetes to standard versus aggressive lipid and blood pressure goals for 36 months. To report strategies used to achieve and maintain lipid goals and to report adverse events (AEs). Adults with type 2 diabetes and no history of cardiovascular disease (N=499) were randomized to standard (low-density lipoprotein cholesterol [LDL-C]≤100 mg/dL, non-high-density lipoprotein cholesterol [non-HDL-C]≤130 mg/dL) or aggressive (LDL-C≤70 mg/dL, non-HDL-C≤100 mg/dL) targets. An algorithm started with statin monotherapy, adding intestinally acting agents as required to reach LDL-C targets. Triglyceride [TG]-lowering agents were next used to reach non-HDL-C goals. Lipid management was performed by mid-level practitioners, with physician consultation, using point-of-care lipid determinations. On average, both groups achieved the LDL-C and non-HDL-C goals within 12 months and maintained them throughout the study. At 36 months, mean (SD) LDL-C and non-HDL-C were 72 (24) and 102 (29) mg/dL in the aggressive group (AGG) and 104 (20) and 138 (26) mg/dL, respectively, in the standard group (STD); systolic blood pressure targets were 115 and 130 mmHg, respectively. 68% of participants reached target LDL-C for >50% of the visits and 46% for >75% of visits. At 36 months, the AGG averaged 1.5 lipid lowering medications and the STD 1.2. Statins were used in 91% and 68% of the AGG and STD; ezetimibe by 31% and 10%; fibrates by 8% and 18%. No serious adverse events (SAEs) were observed; AEs occurred in 18% of the AGG and 14% of the STD. Standard and aggressive lipid targets can be safely maintained in diabetic patients. Standardized algorithms, point-of-care lipid testing, and non-physician providers facilitate care delivery.
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影响因子：
4.8
作者：
Russell, Marie;Fleg, Jerome L.;Howard, Barbara V.
通讯作者：
Howard, Barbara V.
DOI：
10.1056/nejmoa1001282
发表时间：
2010-04-29
期刊：
The New England journal of medicine
影响因子：
--
作者：
ACCORD Study Group;Ginsberg HN;Elam MB;Lovato LC;Crouse JR 3rd;Leiter LA;Linz P;Friedewald WT;Buse JB;Gerstein HC;Probstfield J;Grimm RH;Ismail-Beigi F;Bigger JT;Goff DC Jr;Cushman WC;Simons-Morton DG;Byington RP
通讯作者：
Byington RP
DOI：
10.1111/j.1751-7176.2009.00121.x
发表时间：
2009-10
期刊：
Journal of clinical hypertension (Greenwich, Conn.)
影响因子：
--
作者：
Weir MR;Yeh F;Silverman A;Devereux RB;Galloway JM;Henderson JA;Howard WJ;Russell M;Wilson C;Ratner R;Sorkin J;Umans JG;Fleg JL;Stylianou M;Lee E;Howard BV
通讯作者：
Howard BV
影响因子：
16.2
作者：
Howard, BV;Best, LG;Devereux, RB
通讯作者：
Devereux, RB
影响因子：
16.2
作者：
Brunzell, John D.;Davidson, Michael;Witztum, Joseph L.
通讯作者：
Witztum, Joseph L.