In addition, CIMT can be assessed quickly, non-invasively, and inexpensively with high-resolution ultrasound and therefore changes in CIMT might be a useful early measurement of treatment response. Recently, in particular rapid progression of CIMT has been associated with adverse cardiovascular outcome. Therefore it would be crucial to identify those subjects with the highest residual risk in order to intensify preventive therapies.Ĭommon carotid artery intima-media thickness (CIMT), measured by B-mode ultrasound, is a validated surrogate measure of preclinical atherosclerosis and was shown to be a predictor of future cardiovascular events. However, epidemiologic data suggest that the cardiovascular risk attributable to type 2 diabetes remains about two-fold increased even after adjustment for established risk factors such as hyperglycaemia, hypertension or hyperlipidaemia. The STENO-2 study was the first study which impressively demonstrated a halving of the risk for cardiovascular events and mortality by target driven, intensified, multifactorial risk factor intervention compared to conventional, less stringent risk factor management. Patients with type 2 diabetes face a significantly increased risk for cardiovascular events as well as mortality compared to subjects without diabetes. Trial registrationĬlinical Trial Registration – Unique identifier: NCT00660790 None of the biomarkers used including endothelial function parameters or endothelial progenitor cells turned out to be useful to predict CIMT changes. Intensification of risk factor intervention in type 2 diabetes results in CIMT regression over a period of 2 years. None of the investigated surrogate measures, however, was able to predict changes in IMT early after treatment intensification. Mean CIMT significantly decreased from baseline to 2 year (0.883 ± 0.120 mm vs. Resultsīlood glucose, lipids and blood pressure significantly improved during the first 3 months of intensified treatment, which was sustained over the 2-year study duration. Additional, explorative statistical data analysis was done on CIMT progression building a linear multivariate regression model. For testing differences between before and after multifactorial treatment measurements we used either the paired student’s t-test or the Wilcoxon signed-rank test, depending on the distribution of the data. We also assessed markers of mechanical and biochemical endothelial function and endothelial progenitor cells before and after 3 months of treatment intensification. ![]() The primary outcome was the change in CIMT after 2 years. Treatment was intensified according to current guidelines over 3 months with the aim to maintain intensification over 2 years. HbA 1c > 7.5% (58 mmol/mol) LDL-cholesterol >3.1 mmol/l or blood pressure >140/90 mmHg. In this prospective, open, 2-years study, we included 97 patients with type 2 diabetes and at least two insufficiently treated cardiovascular risk factors, i.e. The aim of this study was to investigate the impact of multiple risk factor intervention on CIMT progression and to establish whether new cardiovascular surrogate measurements would allow prediction of CIMT changes. Patients with rapid progression of carotid intima media thickness (CIMT) were shown to have a higher future risk for cardiovascular events.
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