{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:26:09Z","timestamp":1773411969613,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2012,10,8]],"date-time":"2012-10-08T00:00:00Z","timestamp":1349654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2002<\/jats:bold> To describe the total cardiovascular burden (cardiovascular morbidity or mortality, revascularization or non\u2010traumatic amputation) in individuals with screen\u2010detected diabetes in the ADDITION\u2010Europe trial and to quantify the impact of the intervention on multiple cardiovascular events over 5\u2003years.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> In a pragmatic, cluster\u2010randomized, parallel\u2010group trial in four centres (Denmark; Cambridge, UK; the Netherlands; and Leicester, UK), 343 general practices were randomized to screening plus routine care (<jats:italic>n<\/jats:italic>\u2003=\u20031379 patients), or screening and promotion of target\u2010driven, intensive treatment of multiple risk factors (<jats:italic>n<\/jats:italic>\u2003=\u20031678). We estimated the effect of the intervention on multiple cardiovascular events after diagnosis of diabetes using the Wei, Lin and Weissfeld method.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Over 5.3\u2003years, 167 individuals had exactly one cardiovascular event, 53 exactly two events, and 18 three or more events. The incidence rates (95%\u2003CI) of first events and any event per 1000 person\u2010years were 14.6 (12.8\u201316.6) and 20.4 (18.2\u201322.6), respectively. There were non\u2010significant reductions in the risk of a first (hazard ratio 0.83, 95%\u2003CI 0.65\u20131.05) and second primary endpoint (hazard ratio 0.70, 95%\u2003CI 0.43\u20131.12). The overall average hazard ratio for any event was 0.77 (95%\u2003CI 0.58\u20131.02).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Early intensive multifactorial treatment was not associated with a significant reduction in total cardiovascular burden at 5\u2003years. Focusing on first events in cardiovascular disease prevention trials underestimates the total cardiovascular burden to patients and the health service.<\/jats:p>","DOI":"10.1111\/j.1464-5491.2012.03759.x","type":"journal-article","created":{"date-parts":[[2012,7,23]],"date-time":"2012-07-23T14:55:22Z","timestamp":1343055322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Does early intensive multifactorial treatment reduce total cardiovascular burden in individuals with screen\u2010detected diabetes? Findings from the ADDITION\u2010Europe cluster\u2010randomized trial"],"prefix":"10.1111","volume":"29","author":[{"given":"R. K.","family":"Simmons","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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