Abstract 10490: Vitamin E Supplementation May Provide Cardiovascular Benefit to Hp 2-2 Diabetic Individuals Over and Above That Which Can be Obtained by Treating to Target for LDL and HbA1c
Introduction: The treat to target paradigm for individuals with Diabetes Mellitus (DM) encourages physicians to aggressively control their patient's HbA1c and LDL to lower than 7 or 7.5 and 100 mg/dl respectively. However, it is clear that even when these targets are achieved the risk of vascular complications in DM individuals remains extraordinarily high. We have previously demonstrated that Hp 2-2 DM individuals treated with vitamin E had a 40% reduction in the incidence of major cardiovascular events in the ICARE and HOPE trials and that this treatment was additive to the benefit provided by statin therapy. We sought to determine if vitamin E therapy provided benefit to ICARE participants who were treated to target for LDL and glycemic control.
Hypothesis: We proposed that vitamin E may have reduced the incidence of major cardiovascular events in Hp 2-2 DM individuals from ICARE who had achieved prior to enrollment target HbA1c and LDL levels.
Methods: We analyzed the incidence of the cardiovascular composite endpoint of MI, Stroke and CVD death in Hp 2-2 DM participants of the ICARE study in individuals with a baseline LDL of <100 mg/dl and an HbA1c of 7 or 7.5.
Results: Approximately one third of the ICARE cohort had achieved treatment targets (LDL of less than 100mg/dl and HbA1c of <7.5) prior to commencing the study. Vitamin E treatment significantly decreased the event rate of MI, Stroke and CVD death compared to placebo in Hp 2-2 individuals with a baseline LDL of less than 100 mg/dl and a baseline HbA1c lower than 7.5 (0.7% vs. 4.3% respectively, p=0.04) as well as in individuals with a baseline LDL of less than 100mg/dl and a baseline HbA1c lower than 7 (1% vs. 4.8% respectively, p=0.1).
Conclusions: Vitamin E supplementation may provide cardiovascular benefit to Hp 2-2 DM individuals over and above that which may be attainable by treating to accepted targets for LDL and HbA1c.
- © 2010 by American Heart Association, Inc.