ACCORD
Action to Control Cardiovascular Risk in Diabetes
Patient / Population Intervention / Exposure Comparison Outcome
In 10,251 patients with long-standing T2DM and CV disease or risk factors, intensive glucose control targeting HbA1c <6.0 % increased all-cause mortality compared with standard control (7.0–7.9 %).
N
10,251
Design
RCT, stopped early at 3.5 yr
Endpoint
Non-fatal MI, non-fatal stroke or CV death
Relevance
1
ResultAll-cause mortality 5.0% vs 4.0% (257 vs 203 deaths); HR 1.22 (95% CI 1.01–1.46; p=0.04). Primary composite HR 0.90 (95% CI 0.78–1.04; p=0.16).
ACCORD Study Group. N Engl J Med. 2008;358(24):2545-2559. 10.1056/NEJMoa0802743
Discussion & critique
Established the harm of over-aggressive glucose-lowering in long-standing T2DM and underpins individualised HbA1c targets.