NDLI: Sex-difference of multifactorial intervention on cardiovascular and mortality risk in DKD: post-hoc analysis of a randomised clinical trial

Content Provider	Springer Nature : BioMed Central
Author	Minutolo, Roberto Simeon, Vittorio De Nicola, Luca Chiodini, Paolo Galiero, Raffaele Rinaldi, Luca Caturano, Alfredo Vetrano, Erica Sardu, Celestino Marfella, Raffaele Sasso, Ferdinando Carlo Lampitella Jr, A. Lampitella, A. Lanzilli, A. Lascar , N. Masi, S. Mattei, P. Mastrilli, V. Memoli , P. Minutolo, R. Nasti, R. Pagano, A. Pentangelo , M. Pisa, E. Rossi , E. Sasso, F. C Sorrentino, S. Torella , R. Troise, R. Trucillo, P. Turco, A. A. Turco,, S. Zibella, F. Zirpoli, L.
Abstract	Objective Women with type 2 diabetes experience higher cardiovascular and mortality risk than men possibly because of a sub-optimal cardio-protective treatment. We evaluated whether an intensive multifactorial therapy (MT) produces similar protective effect on development of adverse outcomes in women and men. Research design and methods Nephropathy in Diabetes type 2 study is an open-label cluster randomized trial comparing the effect of Usual Care (UC) or MT of main cardiovascular risk factors (blood pressure < 130/80 mmHg, HbA1c < 7%, LDL < 100 mg/dL, and total cholesterol < 175 mg/dL) on cardiovascular and mortality risk in patients with type 2 diabetes. In this post-hoc analysis, we stratified patients by sex to compare the occurrence of MACEs (primary endpoint) and all-cause death (secondary endpoint) between women (104 MT and 105 UC) and men (103 MT and 83 UC). Results Achievement of therapeutic goals was similar by sex, with 44% and 47% of women and men in MT achieving at least 3 targets vs. 16% and 20% of women and men in UC. During a median follow-up of 13.0 years, we recorded 262 MACE (48.5% in women) and 189 deaths (53.6% in women). Compared to the UC group, the risk of MACE in the MT group was reduced by 52% in women and by 44% in men (P = 0.11). Conversely, the reduction in mortality risk by MT was greater in women (44% versus 12%, P = 0.019). Conclusions MT similarly reduces the risk of MACEs in either sex. This therapeutic approach is associated with a survival advantage in women as compared with men and it may represent an important rationale to motivate physicians in overcoming their therapeutic inertia often encountered in female patients as well as to encourage patients of both sexes at improving their adherence to multidrug therapy.
Related Links	https://cardiab.biomedcentral.com/counter/pdf/10.1186/s12933-024-02371-3.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14752840
DOI	10.1186/s12933-024-02371-3
Journal	Cardiovascular Diabetology
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2024-08-05
Access Restriction	Open
Subject Keyword	Diabetes Angiology Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Internal Medicine Endocrinology, Diabetes and Metabolism
Journal Impact Factor	8.5/2023
5-Year Journal Impact Factor	8.9/2023

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