Treatment and Risk Factor Determinants of Cardiovascular Outcomes in BARI 2D
BARI 2D 心血管结局的治疗和危险因素决定因素
基本信息
- 批准号:8625130
- 负责人:
- 金额:$ 10.91万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2013
- 资助国家:美国
- 起止时间:2013-09-19 至 2015-07-31
- 项目状态:已结题
- 来源:
- 关键词:AnatomyAngioplastyAtherosclerosisBiochemicalBiological MarkersBlood GlucoseBypassC-reactive proteinCardiacCardiovascular systemCessation of lifeCharacteristicsClinicalCoagulation ProcessComplexCoronaryCoronary ArteriosclerosisCoronary Artery BypassCoronary heart diseaseDataData AnalysesDiabetes MellitusEarly InterventionEventFibrin fragment DFibrinogenFibrinolysisGlycosylated hemoglobin AHyperglycemiaIndividualInflammationInsulinInvestigationLaboratory StudyLipidsMeasuresMedicalMetabolicMethodsMissionMulti-Institutional Clinical TrialMyocardial InfarctionMyocardial IschemiaNational Heart, Lung, and Blood InstituteNon-Insulin-Dependent Diabetes MellitusOutcomePatientsPersonsPharmaceutical PreparationsPlasminogen Activator Inhibitor 1ProceduresPrognostic MarkerRandomizedRandomized Clinical TrialsRecording of previous eventsRiskRisk FactorsSeveritiesSpecific qualifier valueStrokeSurgical ManagementSymptomsTestingThrombosisTimeTreatment FactorTreatment ProtocolsWorkadipokinesbasecardiovascular risk factorclinical practicedesigndiabetes riskfollow-upglycemic controlhigh riskimprovedmortalitypatient populationpercutaneous coronary interventionprognosticpublic health relevancetreatment strategy
项目摘要
PROJECT SUMMARY ABSTRACT
Patients with coronary artery disease and type 2 diabetes mellitus are at higher risk for cardiac events than
those with coronary disease but no history of diabetes. Interactions among hyperglycemia, treatment to
lower blood glucose, cardiac risk factors and coronary revascularization are complex and not well
delineated. The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Trial is a multi-
center randomized clinical trial that treated and followed 2368 patients with type 2 diabetes and
documented coronary artery disease. The 2x2 factorial design simultaneously compared cardiac and
diabetes treatment strategies: 1) prompt revascularization with intensive medical therapy versus intensive
medical therapy with revascularization only when clinically indicated, and 2) an insulin sensitization versus
an insulin provision approach to glycemic control, both on clinical cardiovascular outcomes. During the five-
year follow-up, plasminogen activator inhibitor-1 (PAI-1), C-reactive protein (CRP), fibrinogen, and D-dimer
were lower in the insulin sensitization group compared with the insulin provision group, indicating a lower
risk of coagulation, inflammation, and thrombosis. However, neither all-cause mortality nor major
cardiovascular events (composite of death, myocardial infarction and stroke) differed significantly among
the randomized treatment strategy groups in the overall trial. When coronary artery bypass surgery (CABG)
was pre-specified as the intended method of revascularization, prompt revascularization significantly
reduced major cardiovascular events compared with initial medical therapy, and, the rate of major
cardiovascular events was lowest among patients assigned to the combination of prompt revascularization
and insulin sensitization. New data from core laboratory studies of adipokines are available to be analyzed
with metabolic variables including HbA1c and lipids. The purpose of this application is to determine the risk
of major cardiovascular events for patients with type 2 diabetes and coronary artery disease based on their
multifactorial risk factor profile and treatment regimens over the course of five years of follow-up. We will
create a BARI 2D Risk Score from baseline demographic, clinical, angiographic, and biochemical risk
factors, obtaining a prognostic indicator of long-term risk of cardiovascular clinical outcomes. Moreover, we
will evaluate how follow-up measures of the aforementioned risk factors predict death and cardiovascular
events. We will test if the relationship between these risk factors and clinical outcomes depends on the
randomized glycemic and cardiac treatment approaches. We hypothesize that biomarkers measured in
BARI 2D, along with HbA1c level and severity of coronary disease can identify subsets of patients who will
benefit from specified glycemic and cardiac treatment strategies. Such results would have important clinical
implications for the treatment of the large and growing population of patients with type 2 diabetes and stable
ischemic heart disease.
项目摘要
项目成果
期刊论文数量(0)
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科研奖励数量(0)
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Maria Mori Brooks其他文献
ORBITA revisited: what it really means and what it does not?
重新审视 ORBITA:它的真正含义是什么,不是什么?
- DOI:
10.1093/eurheartj/ehx796 - 发表时间:
2018 - 期刊:
- 影响因子:39.3
- 作者:
B. Chaitman;Maria Mori Brooks;K. Fox;T. Lüscher - 通讯作者:
T. Lüscher
Relationships between substance use treatment facilities and alcohol-attributable mortality across U.S. counties
美国各县药物使用治疗机构与酒精归因死亡率之间的关系
- DOI:
10.1016/j.addbeh.2025.108364 - 发表时间:
2025-09-01 - 期刊:
- 影响因子:3.600
- 作者:
Natalie Sumetsky;Maria Mori Brooks;Jeanine Buchanich;Brooke S.G. Molina;Christina Mair - 通讯作者:
Christina Mair
CULTURING BLASTOCYSTS TO DAY 7 OF DEVELOPMENT YIELDS DECREASED ODDS OF LIVE BIRTH FOLLOWING EUPLOID FROZEN EMBRYO TRANSFER
- DOI:
10.1016/j.fertnstert.2024.07.886 - 发表时间:
2024-10-01 - 期刊:
- 影响因子:
- 作者:
Belita Opene;Nicole M. Fischer;Alexandra A. Szczupak;Roy G. Handelsman;Julie M. Rios;Maria Mori Brooks;Jiaxuan Duan;Bernadette Paternoster;G. David Ball;Pamela B. Parker;Melissa Lombardozzi - 通讯作者:
Melissa Lombardozzi
Maria Mori Brooks的其他文献
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{{ truncateString('Maria Mori Brooks', 18)}}的其他基金
The Study of Women's Health Across the Nation (SWAN): The Impact of Midlife and the Menopause Transition on Health and Functioning in Early Old Age
全国妇女健康研究 (SWAN):中年和更年期过渡对早年健康和功能的影响
- 批准号:
10911525 - 财政年份:2020
- 资助金额:
$ 10.91万 - 项目类别:
2/2 Sickle Cell Disease and CardiovAscular Risk - Red cell Exchange Trial (SCD-CARRE Trial)
2/2 镰状细胞病和心血管风险 - 红细胞交换试验(SCD-CARRE 试验)
- 批准号:
10402934 - 财政年份:2019
- 资助金额:
$ 10.91万 - 项目类别:
2/2 Sickle Cell Disease and CardiovAscular Risk - Red cell Exchange Trial (SCD-CARRE Trial)
2/2 镰状细胞病和心血管风险 - 红细胞交换试验(SCD-CARRE 试验)
- 批准号:
10163253 - 财政年份:2019
- 资助金额:
$ 10.91万 - 项目类别:
2/2 Sickle Cell Disease and CardiovAscular Risk - Red cell Exchange Trial (SCD-CARRE Trial)
2/2 镰状细胞病和心血管风险 - 红细胞交换试验(SCD-CARRE 试验)
- 批准号:
9926916 - 财政年份:2019
- 资助金额:
$ 10.91万 - 项目类别:
2/2 Sickle Cell Disease and CardiovAscular Risk - Red cell Exchange Trial (SCD-CARRE Trial)
2/2 镰状细胞病和心血管风险 - 红细胞交换试验(SCD-CARRE 试验)
- 批准号:
10642928 - 财政年份:2019
- 资助金额:
$ 10.91万 - 项目类别:
Myocardial Ischemia and Transfusion (MINT) - DCC
心肌缺血和输血 (MINT) - DCC
- 批准号:
10290738 - 财政年份:2016
- 资助金额:
$ 10.91万 - 项目类别:
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