Posted on March 21, 2019


The DIGAMI 2 Trial is reviewed and summarized including methods, results and conclusions. The primary and secondary endpoints and inclusion and exclusion . The DIGAMI Trial is reviewed and summarized including methods, results and conclusions. The primary and secondary endpoints are included as well as. Methods and results DIGAMI 2 recruited patients (mean age 68 years; 67% males) with type 2 diabetes and suspected acute myocardial.

Author: Turisar Kibei
Country: Montenegro
Language: English (Spanish)
Genre: Personal Growth
Published (Last): 20 June 2013
Pages: 447
PDF File Size: 20.58 Mb
ePub File Size: 11.25 Mb
ISBN: 133-6-23824-437-8
Downloads: 56340
Price: Free* [*Free Regsitration Required]
Uploader: Gagami

The secondary objective was to compare total mortality between groups 2 and 3, whereas morbidity differences served as tertiary objectives. After 2 years of follow-up, the Kaplan—Meier estimated mortality was The outcome of DIGAMI 2 contrasts with the findings in the first DIGAMI trial, which concluded that an insulin—glucose infusion followed by insulin-based therapeutic regime reduced mortality in diabetic patients with acute myocardial infarction.

The adherence to the glucose—insulin infusion prescribed for patients in groups 1 and 2 was high. Written informed consent was obtained from all patients prior to enrolment.

DIGAMI 2 trial post hoc analysis: Lessons in overinterpretation | MD Magazine

After an average of 3. Telecommunicated information about baseline variables were transferred into the computer and the subsequent randomization was based on an algorithm including important prognostic markers in the first DIGAMI trial 910 as follows: The Steering Committee decided to stop patient recruitment on 21 Maywith the digxmi follow-up scheduled for 15 December Oxford University Press is a department of the University of Oxford.

However, diggami epidemiological analysis confirms that the glucose level is a strong, independent predictor of long-term mortality in this patient category, underlining that glucose control seems to be an important digaki of their management. Comparisons among groups were accordingly done both for crude and for adjusted HRs.

Evaluation of risk factors for development of complications in type 2 diabetes in Europe. This is demonstrated by the higher baseline blood glucose Outcome of patients with diabetes mellitus and acute myocardial infarction treated with thrombolytic agents.

  IEC 61557-6 PDF

Patients with diabetes have an unfavourable prognosis after an acute myocardial infarction. The Steering Committee repeatedly emphasized the importance of a strict adherence to the set targets for glucose control in study group 1. The Euro Heart Survey on diabetes and the heart.

Outcome benefit of insulin therapy in the crtitical ill: Lewis-Barned; study nurses, L. Karolinska University Hospital, Stockholm central study office: The hypothesis behind the study was that early digai continued insulin-based metabolic control is a key to mortality diigami. The corresponding proportion in group 3 was Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction DIGAMI study: The study conformed to good clinical practice guidelines and followed the recommendations of the Helsinki Declaration.

The most likely reasons for this beneficial outcome are a combination of improved glucose control and an extensive use of evidence-based treatment as prescribed by the protocol. Dgiami 12 Most Read Stories of The dilemma of professional and industry relations for medical education. With regard to the open study design, the protocol stated that the use of concomitant treatment should be as uniform as possible and according to evidence-based international guidelines for acute myocardial infarction.

Random blood glucose was obtained as soon as possible after hospital admission. DIGAMI 2 was a multicentre, prospective randomized, open trial with blinded evaluation comparing three different management strategies in patients with type 2 diabetes and acute myocardial infarction. Blood glucose was significantly reduced after 24 h 22 all groups, more in groups 1 and 2 9.

The study used 3 treatment sigami The reason was slow patient recruitment.

DIGAMI 2 trial post hoc analysis: Lessons in overinterpretation

Fasting blood glucose represents updated values during the time of follow-up. This caused the patients in group 3 to be somewhat less sick than those in groups 2 and 3.


In addition, an excessive oxidation of free fatty acids may possibly jeopardize non-ischaemic parts of the myocardium. Thank you for submitting a comment on this article.

Exclusion criteria were inability to cope with insulin treatment or to receive information on the study; residence outside the hospital catchment area; participation in other studies, or previous participation in DIGAMI 2. Top 10 Painkillers in the US.

The corresponding values for fasting blood glucose were 8. Apart from the initial insulin—glucose infusion given to patients in group 2, the glucose-lowering treatment in groups 2 and 3 was at the discretion of the responsible physician and according to local routines. DIGAMI 2 did not support the fact that an acutely introduced, long-term insulin treatment improves survival in type 2 diabetic patients following myocardial infarction when compared with a conventional management at similar levels of glucose control or that insulin-based treatment lowers the number of non-fatal myocardial reinfarctions and strokes.

Intensification of therapeutic approaches reduces mortality in diabetic patients with acute myocardial infarction.

The main analysis was performed by means of an un-adjusted Cox proportional hazards model on an intention to treat basis, while the proportional hazards assumption was not assessed. Overall, there were deaths in the study Indeed blood glucose increased in most of these studies during infusion of high concentrations of glucose—insulin—potassium.

There was a trend towards fewer dugami events in groups 2 and 3 compared with group 1. The most important message from this investigation of three different treatment strategies for glucose control in patients with type 2 diabetes and acute myocardial infarction is that they were similar with regard to effects on long- or short-term mortality.