The ACCORD trial was terminated early because intensive glycemic control (HbA1c target <6%) significantly increased which outcome compared to standard control?
- A Cardiovascular mortality ✓
- B Stroke incidence
- C Renal failure rate
- D Peripheral neuropathy
Correct answer: A. Cardiovascular mortality
Explanation
The ACCORD trial demonstrated that intensive glycemic control targeting HbA1c below 6% was associated with a 22% increase in all-cause mortality and a 35% increase in cardiovascular death, leading to early termination of the glycemic arm in 2008. The mechanism is thought to involve hypoglycemia-induced cardiac events and autonomic dysfunction. In contrast, the UKPDS and ADVANCE trials showed cardiovascular benefit with moderate glycemic control, particularly in newly diagnosed patients.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.