Review: Comparing cardiovascular outcomes in diabetes studies

Abstract

iabetes can be considered as a cardiovascular disease leading to the premature death of patients. The increase in cardiovascular risk has been extensively investigated and is associated with a cluster of adverse factors. The effects of various treatments used to affect the pathogenesis of the atherosclerotic process have been investigated in many large trials. A number of issues make the interpretation and comparison of these trials complicated, and in particular the use of a single primary end point such as mortality has been replaced with composite end points. The effects of risk factors and interventions on coronary heart disease (CHD) risk has been converted to cardiovascular disease (CVD) risk for understandable reasons, but this makes the interpretation and comparison of results even more complex. This review provides a critical analysis of outcome studies, highlighting differences in design, end points, patient inclusion and definitions in recent cardiovascular diabetology trials, and examines the potential pitfalls in making unjustified comparisons. Br J Diabetes Vasc Dis 2006; 6:111—18