Key result
Multiple pharmacological interventions for CVD risk factors in T2DM reduced overall cardiovascular events, but failed to reduce all-cause or CVD mortality (no quantitative data reported).
Why the study?
Most clinical trials in T2DM address only one pharmacological intervention at a time, and few studies have explored multi-factorial pharmacological interventions for preventing CVD-related complications. Given therapeutic inertia in managing CVD risk factors, the benefits of a more holistic multiple-intervention approach needed to be established.
Does multiple pharmacological interventions targeting cardiovascular disease risk factors reduce all-cause mortality, CVD mortality, stroke, and cardiovascular events in adults with type 2 diabetes?
Systematic Review
Does multiple pharmacological interventions targeting cardiovascular disease risk factors reduce all-cause mortality, CVD mortality, stroke, and cardiovascular events in adults with type 2 diabetes?
Answers are grounded in this paper and cite their sources.
While current evidence fails to support a benefit of multiple pharmacological interventions on all-cause and cardiovascular mortality in adults with type 2 diabetes, beneficial effects were observed for reducing the overall number of cardiovascular events.
Background: The use of pharmacological agents has been shown to slow down the progression of microvascular and macrovascular complications. Most clinical trials address one pharmacological intervention at a time. To date, only a few studies explored multi-factorial pharmacological interventions in T2DM individuals for preventing CVD related complications. Given the current therapeutic inertia in pharmacological management of CVD risk factors, it is important to establish the benefits of a more holistic approach. Therefore, the aim of this review is to assess the efficacy of multiple pharmacological interventions for cardiovascular diseases (CVD) risk factors with or without conventional care in reducing all cause mortality, CVD mortality, stroke and cardiovascular events among adults with type 2 diabetes. Current evidence fails to support the benefit of multiple pharmacological interventions on all cause mortality and death from cardiovascular causes. However, beneficial effects were seen on the reduction of the overall number of cardiovascular events and there were promising trends for secondary outcomes such as stroke, myocardial infarction, revascularisation and amputation.
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Khalil et al. (2013) conducted a systematic review in Type 2 diabetes mellitus. Multiple pharmacological interventions targeting cardiovascular disease risk factors vs. Conventional care or single intervention was evaluated on All-cause mortality, cardiovascular mortality, stroke, and cardiovascular events. Multiple pharmacological interventions for CVD risk factors in T2DM reduced overall cardiovascular events, but failed to reduce all-cause or CVD mortality (no quantitative data reported).
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