# Haptoglobinefenotype wijzigt het effect van intensieve glycemische controle op CV-uitkomsten

*geplaatst 2020-02-11 · Preventie · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2019.11.051 · https://hartvaat.nl/2020/02/11/haptoglobinefenotype-wijzigt-het-effect-van-intensieve-glycemische-controle-op-c/*

Studie die aantoont dat het haptoglobinefenotype het cardiovasculaire effect van intensieve glycemische controle bij diabetes modificeert.

## English: Haptoglobin Phenotype Modifies the Influence of Intensive Glycemic Control on Cardiovascular Outcomes.

This study showed that haptoglobin phenotype modifies the cardiovascular benefit of intensive glycemic control in diabetes, identifying a pharmacogenomic factor that may explain the variable outcomes of glucose-lowering trials.

## Abstract (original, from the publication)

BACKGROUND: Whereas there exists a direct relationship between glycated hemoglobin and cardiovascular disease (CVD), clinical trials targeting glycated hemoglobin to near-normal levels using intensive therapy have failed to prevent CVD and have even increased mortality, making clinical decision making difficult. A common polymorphism at the haptoglobin (Hp) genetic locus is associated with CVD, especially coronary heart disease, in the setting of hyperglycemia. OBJECTIVES: This study sought to determine whether the treatment difference of intensive versus standard glucose-lowering therapy on risk of CVD events in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study depended on Hp phenotype. METHODS: Hp phenotype was measured within 5,806 non-Hispanic white ACCORD participants using a validated assay. Adjusted hazard ratios (aHR) with 95% confidence intervals (CI) estimated from stratified Cox regression models were used to quantify the association between intensive therapy and incident CVD for the 2 different Hp phenotype groups (Hp2-2, Hp1 carriers). RESULTS: Compared with standard therapy, intensive therapy was associated with a lower risk of incident coronary heart disease among participants with the Hp2-2 phenotype (n = 2,133; aHR: 0.71; 95% CI: 0.55 to 0.91; p = 0.006), but not among the other 2 phenotypes (Hp1 allele carriers) (n = 3,673; aHR: 0.95; 95% CI: 0.79 to 1.13; p = 0.550). The same pattern was observed for CVD. Conversely, intensive therapy was associated with an increased risk of fatal CVD (aHR: 1.50; 95% CI: 1.00 to 2.25; p = 0.049) and total mortality (aHR: 1.40; 95% CI: 1.08 to 1.81; p = 0.011) among the Hp1 carriers, whereas this risk was not increased in the Hp2-2 phenotype (fatal CVD: aHR: 1.02; 95% CI: 0.59 to 1.77; p = 0.931; total mortality: aHR: 0.98; 95% CI: 0.68 to 1.41; p = 0.908). CONCLUSIONS: Intensive glucose-lowering therapy was effective at preventing incident coronary heart disease and CVD events in ACCORD study participants with the Hp2-2 phenotype but not in Hp1 carriers, who had increased mortality risk from intensive therapy.

Auteurs: Allie S Carew, Andrew P Levy, Henry N Ginsberg, Steven Coca, Orit Lache, Thomas Ransom, Robert Byington, Eric B Rimm, John Sapp, Martin Gardner, Leah E Cahill

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2019.11.051. Bijgewerkt 2026-07-03T13:27:36Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.