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DREAM: Rosiglitazone reduced diabetes, renal disease but increased risk for heart failure

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Neither ramipril nor rosiglitazone was successful in reducing the risk for cardiorenal composite outcome, according to newly published findings from the DREAM trial.

Investigators randomly assigned 5,269 individuals to 15 mg per day of ramipril (Altace, King Pharmaceuticals) vs. placebo or 8 mg per day of rosiglitazone (Avandia, GlaxoSmithKline) vs. placebo. Individuals had no history of cardiovascular disease or renal insufficiency at baseline.

During three years of follow-up, there was little reduction in the risk for cardiorenal composite outcome among those assigned to ramipril (15.7% vs. 16%) and rosiglitazone (15% vs. 16.8%).

Further, ramipril had no impact on CVD or renal components. Rosiglitazone reduced diabetes and development of renal disease but had no effect on cardiorenal outcome and actually increased the risk for heart failure (0.53% vs. 0.08%). However, the risk for heart failure in this analysis was lower than the risk found in similar thiazolidinedione trials. Prevention of diabetes was independently associated with prevention of the renal component, according to the investigators. – by Katie Kalvaitis

Diabetes Care. 2008;31:1007-1014.