Effects of ramipril and rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose

The Dream Trial Investigators

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

OBJECTIVE- Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) are risk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined the effects of ramipril and rosiglitazone on combined and individual CVD and renal outcomes in people with IGT and/or IFG in the Diabetes REduction Assessment With ramipril and rosiglitazone Medication (DREAM) trial. RESEARCH DESIGNANDMETHODS- A total of 5,269 people aged > 30 years, with IGT and/or IFG without known CVD or renal insufficiency, were randomized to 15 mg/day ramipril versus placebo and 8 mg/day rosiglitazone versus placebo. A composite cardiorenal outcome and its CVD and renal components were assessed during the 3-year follow-up. RESULTS- Compared with placebo, neither ramipril (15.7% [412 of 2,623] vs. 16.0% [424 of 2,646]; hazard ratio [HR] 0.98 [95% CI 0.84 -1.13]; P=0.75) nor rosiglitazone (15.0% [394 of 2,635] vs. 16.8% [442 of 2,634]; 0.87 [0.75-1.01]; P = 0.07) reduced the risk of the cardiorenal composite outcome. Ramipril had no impact on the CVD and renal components. Rosiglitazone increased heart failure (0.53 vs. 0.08%; HR 7.04 [95% CI 1.60 -31.0]; P = 0.01) but reduced the risk of the renal component (0.80 [0.68-0.93]; P = 0.005); prevention of diabetes was independently associated with prevention of the renal component (P < 0.001). CONCLUSIONS- Ramipril did not alter the cardiorenal outcome or its components. Rosiglitazone, which reduced diabetes, also reduced the development of renal disease but not the cardiorenal outcome and increased the risk of heart failure.

Original languageEnglish
Pages (from-to)1007-1014
Number of pages8
JournalDiabetes Care
Volume31
Issue number5
DOIs
Publication statusPublished - 01-05-2008
Externally publishedYes

Fingerprint

rosiglitazone
Ramipril
Glucose Intolerance
Fasting
Cardiovascular Diseases
Kidney
Glucose
Placebos
Heart Failure
Kidney Diseases
Renal Insufficiency

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

@article{040a484b91214777b7633730f69902d8,
title = "Effects of ramipril and rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose",
abstract = "OBJECTIVE- Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) are risk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined the effects of ramipril and rosiglitazone on combined and individual CVD and renal outcomes in people with IGT and/or IFG in the Diabetes REduction Assessment With ramipril and rosiglitazone Medication (DREAM) trial. RESEARCH DESIGNANDMETHODS- A total of 5,269 people aged > 30 years, with IGT and/or IFG without known CVD or renal insufficiency, were randomized to 15 mg/day ramipril versus placebo and 8 mg/day rosiglitazone versus placebo. A composite cardiorenal outcome and its CVD and renal components were assessed during the 3-year follow-up. RESULTS- Compared with placebo, neither ramipril (15.7{\%} [412 of 2,623] vs. 16.0{\%} [424 of 2,646]; hazard ratio [HR] 0.98 [95{\%} CI 0.84 -1.13]; P=0.75) nor rosiglitazone (15.0{\%} [394 of 2,635] vs. 16.8{\%} [442 of 2,634]; 0.87 [0.75-1.01]; P = 0.07) reduced the risk of the cardiorenal composite outcome. Ramipril had no impact on the CVD and renal components. Rosiglitazone increased heart failure (0.53 vs. 0.08{\%}; HR 7.04 [95{\%} CI 1.60 -31.0]; P = 0.01) but reduced the risk of the renal component (0.80 [0.68-0.93]; P = 0.005); prevention of diabetes was independently associated with prevention of the renal component (P < 0.001). CONCLUSIONS- Ramipril did not alter the cardiorenal outcome or its components. Rosiglitazone, which reduced diabetes, also reduced the development of renal disease but not the cardiorenal outcome and increased the risk of heart failure.",
author = "{The Dream Trial Investigators} and Dagenais, {Gilles R.} and R. Diaz and Guerrero, {R. Ahuad} and J. Albisu and Alvarez, {M. S.} and V. Arregui and H. Avaca and H. Baglivo and M. Balbuena and F. Bello and J. Bono and M. Botto and L. Brandani and M. Brandes and D. Bruera and Venere, {R. Cabral} and A. Caccavo and A. Cacurri and G. Caime and M. Capozzi and A. Carrique and P. Carrique and L. Cartasegna and J. Casabe and G. Casaccia and C. Castellanos and L. Castro and G. Cendali and P. Cerchi and M. Cerdan and M. Cinalli and M. Cipullo and M. Cismondi and N. Citta and L. Citta and C. Crespo and P. Crunger and C. Cuneo and {De Loredo}, L. and {De Loredo}, S. and {Del Cerro}, S. and R. Denaro and E. Esperatti and L. Esposito and H. Farras and S. Fernandez and M. Fernandez and A. Fernandez and G. Ferrari and C. Rao",
year = "2008",
month = "5",
day = "1",
doi = "10.2337/dc07-1868",
language = "English",
volume = "31",
pages = "1007--1014",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
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}

Effects of ramipril and rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose. / The Dream Trial Investigators.

In: Diabetes Care, Vol. 31, No. 5, 01.05.2008, p. 1007-1014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of ramipril and rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose

AU - The Dream Trial Investigators

AU - Dagenais, Gilles R.

AU - Diaz, R.

AU - Guerrero, R. Ahuad

AU - Albisu, J.

AU - Alvarez, M. S.

AU - Arregui, V.

AU - Avaca, H.

AU - Baglivo, H.

AU - Balbuena, M.

AU - Bello, F.

AU - Bono, J.

AU - Botto, M.

AU - Brandani, L.

AU - Brandes, M.

AU - Bruera, D.

AU - Venere, R. Cabral

AU - Caccavo, A.

AU - Cacurri, A.

AU - Caime, G.

AU - Capozzi, M.

AU - Carrique, A.

AU - Carrique, P.

AU - Cartasegna, L.

AU - Casabe, J.

AU - Casaccia, G.

AU - Castellanos, C.

AU - Castro, L.

AU - Cendali, G.

AU - Cerchi, P.

AU - Cerdan, M.

AU - Cinalli, M.

AU - Cipullo, M.

AU - Cismondi, M.

AU - Citta, N.

AU - Citta, L.

AU - Crespo, C.

AU - Crunger, P.

AU - Cuneo, C.

AU - De Loredo, L.

AU - De Loredo, S.

AU - Del Cerro, S.

AU - Denaro, R.

AU - Esperatti, E.

AU - Esposito, L.

AU - Farras, H.

AU - Fernandez, S.

AU - Fernandez, M.

AU - Fernandez, A.

AU - Ferrari, G.

AU - Rao, C.

PY - 2008/5/1

Y1 - 2008/5/1

N2 - OBJECTIVE- Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) are risk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined the effects of ramipril and rosiglitazone on combined and individual CVD and renal outcomes in people with IGT and/or IFG in the Diabetes REduction Assessment With ramipril and rosiglitazone Medication (DREAM) trial. RESEARCH DESIGNANDMETHODS- A total of 5,269 people aged > 30 years, with IGT and/or IFG without known CVD or renal insufficiency, were randomized to 15 mg/day ramipril versus placebo and 8 mg/day rosiglitazone versus placebo. A composite cardiorenal outcome and its CVD and renal components were assessed during the 3-year follow-up. RESULTS- Compared with placebo, neither ramipril (15.7% [412 of 2,623] vs. 16.0% [424 of 2,646]; hazard ratio [HR] 0.98 [95% CI 0.84 -1.13]; P=0.75) nor rosiglitazone (15.0% [394 of 2,635] vs. 16.8% [442 of 2,634]; 0.87 [0.75-1.01]; P = 0.07) reduced the risk of the cardiorenal composite outcome. Ramipril had no impact on the CVD and renal components. Rosiglitazone increased heart failure (0.53 vs. 0.08%; HR 7.04 [95% CI 1.60 -31.0]; P = 0.01) but reduced the risk of the renal component (0.80 [0.68-0.93]; P = 0.005); prevention of diabetes was independently associated with prevention of the renal component (P < 0.001). CONCLUSIONS- Ramipril did not alter the cardiorenal outcome or its components. Rosiglitazone, which reduced diabetes, also reduced the development of renal disease but not the cardiorenal outcome and increased the risk of heart failure.

AB - OBJECTIVE- Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) are risk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined the effects of ramipril and rosiglitazone on combined and individual CVD and renal outcomes in people with IGT and/or IFG in the Diabetes REduction Assessment With ramipril and rosiglitazone Medication (DREAM) trial. RESEARCH DESIGNANDMETHODS- A total of 5,269 people aged > 30 years, with IGT and/or IFG without known CVD or renal insufficiency, were randomized to 15 mg/day ramipril versus placebo and 8 mg/day rosiglitazone versus placebo. A composite cardiorenal outcome and its CVD and renal components were assessed during the 3-year follow-up. RESULTS- Compared with placebo, neither ramipril (15.7% [412 of 2,623] vs. 16.0% [424 of 2,646]; hazard ratio [HR] 0.98 [95% CI 0.84 -1.13]; P=0.75) nor rosiglitazone (15.0% [394 of 2,635] vs. 16.8% [442 of 2,634]; 0.87 [0.75-1.01]; P = 0.07) reduced the risk of the cardiorenal composite outcome. Ramipril had no impact on the CVD and renal components. Rosiglitazone increased heart failure (0.53 vs. 0.08%; HR 7.04 [95% CI 1.60 -31.0]; P = 0.01) but reduced the risk of the renal component (0.80 [0.68-0.93]; P = 0.005); prevention of diabetes was independently associated with prevention of the renal component (P < 0.001). CONCLUSIONS- Ramipril did not alter the cardiorenal outcome or its components. Rosiglitazone, which reduced diabetes, also reduced the development of renal disease but not the cardiorenal outcome and increased the risk of heart failure.

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U2 - 10.2337/dc07-1868

DO - 10.2337/dc07-1868

M3 - Article

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SP - 1007

EP - 1014

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 5

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