Trial reportDiabetologia2018
Reduced risk of heart failure with intensified multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: 21 years of follow-up in the randomised Steno-2 study.
Trial report in Diabetologia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00320008 (Intensified Multifactorial Intervention in Patients With Type 2 Diabetes and Microalbuminuria), which is not on this map. Cited by 42 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Intensified Multifactorial Intervention in Patients With Type 2 Diabetes and Microalbuminuria
Who cites it
42 citing papers in PubMed, 5 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2026Guideline
- Education programmes for people with chronic kidney disease and diabetes.The Cochrane database of systematic reviews · 2024Pooled it
- Diagnosis, prevention, and treatment of cardiovascular diseases in people with type 2 diabetes and prediabetes: a consensus statement jointly from the Japanese Circulation Society and the Japan Diabetes Society.Diabetology international · 2021Guideline
- Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Diabetes mellitus and risk of new-onset and recurrent heart failure: a systematic review and meta-analysis.ESC heart failure · 2020Pooled it
- Initiation of the SGLT2 inhibitor canagliflozin to prevent kidney and heart failure outcomes guided by HbA1c, albuminuria, and predicted risk of kidney failure.Cardiovascular diabetology · 2022Trial
- Risk Factor Control and Cardiovascular Event Risk in People With Type 2 Diabetes in Primary and Secondary Prevention Settings.Circulation · 2020Trial
- Cardiovascular Benefit of Empagliflozin Across the Spectrum of Cardiovascular Risk Factor Control in the EMPA-REG OUTCOME Trial.The Journal of clinical endocrinology and metabolism · 2020Trial
- Beneficial impact of intensified multifactorial intervention on risk of stroke: outcome of 21 years of follow-up in the randomised Steno-2 Study.Diabetologia · 2019Trial
- A WHO-HPH operational program versus usual routines for implementing clinical health promotion: an RCT in health promoting hospitals (HPH).Implementation science : IS · 2018Trial
- Article
- Epicardial Fat and Heart Failure in Type 2 Diabetes: Metabolism, Imaging and Novel Biomarkers-A Translational Perspective.Journal of clinical medicine · 2025Review
- Cardiovascular Risk Reduction in Patients with Type 2 Diabetes: What Does the Cardiologist Need to Know?European cardiology · 2025Review
- A Review of Contributing Factors to Heart Failure: Genetic, Lifestyle, and Environmental Influences.Journal of pharmacy & bioallied sciences · 2024Article
- Current Position of Gliclazide and Sulfonylureas in the Contemporary Treatment Paradigm for Type 2 Diabetes: A Scoping Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024Article
- Risk factor control and cardiovascular events in patients with type 2 diabetes mellitus.PloS one · 2024Article
- The AHA/ACC/HFSA 2022 Heart Failure Guidelines: Changing the Focus to Heart Failure Prevention.American journal of preventive cardiology · 2023Review
- Guardians For Health: A Practical Approach to Improving Quality of Life and Longevity in People with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023Review
- Diabetic vascular diseases: molecular mechanisms and therapeutic strategies.Signal transduction and targeted therapy · 2023Review
- Intensified Multifactorial Intervention in Patients with Type 2 Diabetes Mellitus.Diabetes & metabolism journal · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisIn type 2 diabetes mellitus, heart failure is a frequent, potentially fatal and often forgotten complication. Glucose-lowering agents and adjuvant therapies modify the risk of heart failure. We recently reported that 7.8 years of intensified compared with conventional multifactorial intervention in individuals with type 2 diabetes and microalbuminuria in the Steno-2 study reduced the risk of cardiovascular disease and prolonged life over 21.2 years of follow-up. In this post hoc analysis, we examine the impact of intensified multifactorial intervention on the risk of hospitalisation for heart failure.
methodsOne hundred and sixty individuals were randomised to conventional or intensified multifactorial intervention, using sealed envelopes. The trial was conducted using the Prospective, Randomised, Open, Blinded Endpoints (PROBE) design. After 7.8 years, all individuals were offered intensified therapy and the study continued as an observational follow-up study for an additional 13.4 years. Heart-failure hospitalisations were adjudicated from patient records by an external expert committee blinded for treatment allocation. Event rates were compared using a Cox regression model adjusted for age and sex.
resultsEighty patients were assigned to each treatment group. Ten patients undergoing intensive therapy vs 24 undergoing conventional therapy were hospitalised for heart failure during follow-up. The HR (95% CI) was 0.30 (0.14, 0.64), p = 0.002 in the intensive-therapy group compared with the conventional-therapy group. Including death in the endpoint did not lead to an alternate overall outcome; HR 0.51 (0.34, 0.76), p = 0.001. In a pooled cohort analysis, an increase in plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) during the first two years of the trial was associated with incident heart failure. CONCLUSIONS/
interpretationIntensified, multifactorial intervention for 7.8 years in type 2 diabetic individuals with microalbuminuria reduced the risk of hospitalisation for heart failure by 70% during a total of 21.2 years of observation.
trial registrationClinicalTrials.gov NCT00320008.
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