23 research outputs found
Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.
Abstract
BACKGROUND:
The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown.
METHODS:
We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy.
RESULTS:
In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups.
CONCLUSIONS:
Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)
Characterization of floral morphology and synchrony among Zea species in Mexico
Pollen and silk attributes as well as floral synchrony are the most important morphological features that influence pollination and gene flow in the genus Zea. To characterize floral morphology and synchrony, 115 teosinte populations, 60 maize accessions representing 53 landraces, three improved open pollinated varieties and 14 commercial hybrids were evaluated. A high level of variation among the Zea populations was found. The pollen size in landraces and commercial hybrids was larger (103-105 ?m) than in teosinte (84 ?m). Teosinte pollen grains of several accessions collapsed at pollen shed but for some populations viability was retained from 30 minutes to one hour. Silks in maize were twice as long as teosinte silks (16 to 27 cm vs 7.2-11.4 cm). Trichome density was five times higher in teosinte silks than in maize silks. Most indigenous teosinte (ssp. mexicana) populations from the Valley of Mexico and Central Plateau areas flowers synchronously with landraces and commercial hybrids. In contrast, tropical teosinte (ssp. parviglumis) flowers 2-3 weeks later than maize. The results of this study are important components to estimate the likelihood of gene flow among species of the genus Zea in Mexico