{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:43:21Z","timestamp":1779911001567,"version":"3.53.1"},"reference-count":19,"publisher":"American Diabetes Association","issue":"7","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>We evaluated the risk of cardiovascular (CV) death in all Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) study participants and in those who experienced an on-study, major nonfatal CV event.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>The study randomly assigned 5,380 patients with type 2 diabetes to alogliptin or placebo within 15 to 90 days of an acute coronary syndrome (ACS). Deaths and nonfatal CV events (myocardial infarction [MI], stroke, hospitalized heart failure [HHF], and hospitalization for unstable angina [UA]) were adjudicated. Patients were monitored until censoring or death, regardless of a prior postrandomized nonfatal CV event. Time-updated multivariable Cox models were used to estimate the risk of death in the absence of or after each nonfatal event.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Rates of CV death were 4.1% for alogliptin and 4.9% for placebo (hazard ratio [HR] 0.85; 95% CI 0.66, 1.10). A total of 736 patients (13.7%) experienced a first nonfatal CV event (5.9% MI, 1.1% stroke, 3.0% HHF, and 3.8% UA). Compared with patients not experiencing a nonfatal event, the adjusted HR (95% CI) for death was 3.12 after MI (2.13, 4.58; P &amp;lt; 0.0001) 4.96 after HHF (3.29, 7.47; P &amp;lt; 0.0001), 3.08 after stroke (1.29, 7.37; P = 0.011), and 1.66 after UA (0.81, 3.37; P = 0.164). Mortality rates after a nonfatal event were comparable for alogliptin and placebo.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In patients with type 2 diabetes and a recent ACS, the risk of CV death was higher after a postrandomization, nonfatal CV event, particularly heart failure, compared with those who did not experience a CV event. The risk of CV death was similar between alogliptin and placebo.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc16-0303","type":"journal-article","created":{"date-parts":[[2016,6,12]],"date-time":"2016-06-12T00:48:14Z","timestamp":1465692494000},"page":"1267-1273","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":46,"title":["Cardiovascular Mortality in Patients With Type 2 Diabetes and Recent Acute Coronary Syndromes From the EXAMINE Trial"],"prefix":"10.2337","volume":"39","author":[{"given":"William B.","family":"White","sequence":"first","affiliation":[{"name":"University of Connecticut School of Medicine, Farmington, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Kupfer","sequence":"additional","affiliation":[{"name":"Takeda Development Center Americas, Inc., Deerfield, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"INSERM 9501, Universite de Lorraine and CHU, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus R.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Harvard School of Public Health, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig A.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Takeda Development Center Americas, Inc., Deerfield, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanyu","family":"Lei","sequence":"additional","affiliation":[{"name":"Harvard Clinical Research Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George L.","family":"Bakris","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E.","family":"Nissen","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Cushman","sequence":"additional","affiliation":[{"name":"The University of Tennessee Health Science Center College of Medicine, Memphis VA Medical Center, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R.","family":"Heller","sequence":"additional","affiliation":[{"name":"University of Sheffield, Sheffield, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M.","family":"Bergenstal","sequence":"additional","affiliation":[{"name":"International Diabetes Center, Park-Nicollet Clinic, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny R.","family":"Fleck","sequence":"additional","affiliation":[{"name":"Takeda Development Center Americas, Inc., Deerfield, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Harvard Clinical Research Institute, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2016,6,12]]},"reference":[{"key":"2022031301121533500_B1","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1056\/NEJMoa1310799","article-title":"Changes in diabetes-related complications in the United States, 1990-2010","volume":"370","author":"Gregg","year":"2014","journal-title":"N Engl J Med"},{"key":"2022031301121533500_B2","doi-asserted-by":"crossref","first-page":"855","DOI":"10.2337\/diacare.26.3.855","article-title":"Development of congestive heart failure in type 2 diabetic patients with microalbuminuria or proteinuria: observations from the DIABHYCAR (type 2 DIABetes, Hypertension, CArdiovascular Events and Ramipril) study","volume":"26","author":"Vaur","year":"2003","journal-title":"Diabetes Care"},{"key":"2022031301121533500_B3","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S2213-8587(14)70031-2","article-title":"Heart failure: a cardiovascular outcome in diabetes that can no longer be ignored","volume":"2","author":"McMurray","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2022031301121533500_B4","doi-asserted-by":"crossref","first-page":"537","DOI":"10.2337\/diacare.14.7.537","article-title":"Trends in prevalence of diabetes mellitus in patients with myocardial infarction and effect of diabetes on survival. 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