Navigation Links
The ORIGIN-GRACE study
Date:8/27/2012

Munich, Germany A sub-study of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial, designed to investigate the effect of insulin glargine and omega-3 fatty acids on atherosclerosis progression, has found that, compared to standard care, only insulin glargine (a long-acting insulin) had a "modest" statistically non-significant reducing effect on the primary outcome of rate of change in maximum carotid intima media thickness (CIMT) at 12 carotid sites.

However, while insulin glargine did significantly reduce the secondary outcomes of the study (the annualised rates of change in maximum CIMT for the common carotid artery and for the common carotid plus bifurcation sites), there was no differences in either the primary or secondary outcomes between the omega-3 polyunsaturated fatty acid supplements and placebo groups.

"Our study demonstrates that in high-risk people with established cardiovascular disease or with cardiovascular risk factors plus type 2 diabetes or pre-diabetes, insulin glargine modestly retards the progression of atherosclerosis," said first investigator Professor Eva Lonn, Professor of Medicine and Population Health Research Scientist at McMaster University, Hamilton, Ontario, Canada.

As background to the trial, known as the Glucose Reduction and Atherosclerosis Continuing Evaluation Study (GRACE) study, Professor Lonn explained that the effects of treatment with insulin titrated to normalise fasting plasma glucose levels and with omega-3 polyunsaturated fatty acid supplements (fish oil supplements) on atherosclerosis progression in people with type 2 diabetes or pre-diabetes are unknown.

The GRACE study assessed the effects of insulin glargine and omega-3 fatty acids by performing yearly high-resolution carotid ultrasound examinations for five years and detailed precise measurements of CIMT. Patients were recruited from 32 centers in seven countries. At baseline patients' mean age was 63 years, over 50% had a history of prior heart attack, stroke or revascularisation, 80% had hypertension, 60% abnormal cholesterol and 10% were current smokers. About 90% had type 2 diabetes and 10% had pre-diabetes.

Most patients were receiving several therapies aimed at reducing their risk for atherosclerosis and its complications. Use of these drugs increased over the duration of the study, so that at study end 52% were on statins, 75% on ACE inhibitors or ARBs, 55% on beta-blockers and 70% on aspirin. Patients received open label insulin glargine targeting normal glucose levels or standard glycemic care, and double-blind therapy with a 1 gram per day supplement of omega-3 fatty acids or placebo. Median follow-up was five years.

Insulin glargine significantly lowered fasting plasma glucose, glycated hemoglobin and triglyceride levels and provided overall "excellent" glycemic control, said Professor Lonn, while omega-3 fatty acid supplements had no significant effect on glycemia or on lipid levels. Both interventions were safe.

Compared with the standard glycemic care, insulin glargine reduced the primary CIMT outcome, but the difference was not statistically significant (difference = 0.0030 0.0021 mm/year; p=0.145) and significantly reduced the secondary outcomes (difference = 0.0033 0.0017 mm/year; p=0.049 and 0.0045 0.0021 mm/year; p=0.032). There was no beneficial effect of omega-3 polyunsaturated fatty acid supplements on either outcome.

"These findings support the cardiovascular safety of this intervention," said Professor Lonn, "and suggest that longer term treatment with insulin glargine might prevent cardiovascular events. In the parent ORIGIN trial insulin glargine had a neutral effect on cardiovascular events over 6.2 years. Whether longer-term therapy may result in clinical event reduction remains currently unproven."

"The neutral effect of omega-3 polyunsaturated fatty acid supplements on atherosclerotic vascular disease is also concordant with the neutral effect on clinical cardiovascular effects in the parent ORIGIN trial. Some, but not all, previous studies reported beneficial effects of omega-3 polyunsaturated fatty acid supplements in cardiovascular event prevention and several large ongoing trials are still evaluating this question. Our study does not address the current recommendations to consume more fish, which may have health benefits not conferred by fish oil supplements."


'/>"/>

Contact: ESC Press Office
press@escardio.org
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. People of normal weight with belly fat at highest death risk, Mayo Clinic study
2. New Blood Thinner Effient No Better Than Plavix at Preventing Heart Trouble: Study
3. Study examines factors associated with improvement in survival from heart attack in France
4. Study: Clot removal devices successful tools for acute ischemic stroke treatment
5. Global study suggests need for strategies to combat unhealthy lifestyles among the poor and the rich
6. Multiple Brain Tumors Even More Malignant: Study
7. Meditation May Help Fight Loneliness, Study Says
8. Spirituality May Boost Mental Health: Study
9. Study identifies human melanoma stem cells
10. Study helps pancreatic cancer patients make hard choices
11. Anorexics Cant Judge Own Body Size: Study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... ... was in a crisis. Her son James, eight, was out of control. Prone to extreme ... “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If there was ... other children and say he was going to kill them. If we were driving ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, CA is excited ... To Recovery® program to drive cancer patients to and from their cancer treatments. ... highest quality of life and ongoing independence. Getting to and from medical treatments ...
(Date:6/24/2016)... York, NY (PRWEB) , ... June 24, 2016 ... ... publication Haute Living, is proud to recognize Dr. Barry M. Weintraub as a ... that “the most beautiful women in the world, and the most handsome men, ...
(Date:6/24/2016)... ... June 24, 2016 , ... Venture Construction Group (VCG) ... held on June 20th at the Woodmont Country Club at 1201 Rockville Pike, ... organization dedicated to helping service members that have been wounded in battle and their ...
(Date:6/24/2016)... ... 2016 , ... To succeed under value-based payments, healthcare providers ... how to move forward, given the need to sustain current operations. PYA has ... an organization’s specific needs. , PYA Principal Martie Ross states, “Healthcare providers want ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016 Bracket , a leading ... next generation clinical outcomes platform, Bracket eCOA (SM) 6.0, ... June 26 – 30, 2016 in Philadelphia ... Clinical Outcome Assessment product of its kind to fully integrate ... Bracket eCOA 6.0 is a flexible platform for electronic ...
(Date:6/23/2016)... , June 23, 2016 Revolutionary ... Oticon , industry leaders in advanced audiology ... of Oticon Opn ™, the world,s first internet ... possibilities for IoT devices.      (Photo: ... introduces a number of ,world firsts,: , ...
(Date:6/23/2016)... , June 23, 2016  Experian Health, ... and transforming the patient payment and care ... innovative new products and services that will ... revenue cycle offerings. These award-winning solutions will ... workflows, remain compliant in an ever-changing environment ...
Breaking Medicine Technology: