title: Evaluation of the dual peroxisome proliferator-activated receptor α/γ agonist aleglitazar to reduce cardiovascular events in patients with acute coronary syndrome and type 2 diabetes mellitus: rationale and design of the AleCardio trial.
abstract: BACKGROUND
  Peroxisome proliferator-activated receptors (PPARs) regulate transcription of genes involved in glucose uptake, lipid metabolism, and inflammation. Aleglitazar is a potent dual PPAR agonist with insulin-sensitizing and glucose-lowering actions and favorable effects on lipid profiles and biomarkers of cardiovascular risk. The AleCardio trial examines whether the addition of aleglitazar to standard medical therapy reduces the risk of cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus and recent acute coronary syndrome.
  
  
  METHODS
  AleCardio is a phase 3, multicenter, randomized, double-blind, placebo-controlled trial. A total of 7,228 patients were randomized to aleglitazar 150 μg or placebo daily in addition to standard medical therapy. The primary efficacy end point is time to the first event of cardiovascular death, myocardial infarction, or stroke. Principal safety end points are hospitalization due to heart failure and changes in renal function. Treatment will continue until 7,000 patients are followed up for at least 2.5 years and 950 primary end point events are adjudicated.
  
  
  CONCLUSIONS
  AleCardio will establish whether the PPAR-α/γ agonist aleglitazar improves cardiovascular outcomes in patients with diabetes and high-risk coronary disease.
authors.affiliation: Cleveland Clinic Coordinating Center for Clinical Research (C5Research), Cleveland, OH. Electronic address: lincofa@ccf.org.
authors.forename: A Michael
authors.initials: AM
authors.lastname: Lincoff
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
authors.forename: Bruce
authors.initials: B
authors.lastname: Neal
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Nicholls
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Schwartz
authors.forename: Klas
authors.initials: K
authors.lastname: Malmberg
authors.forename: John B
authors.initials: JB
authors.lastname: Buse
authors.forename: Robert R
authors.initials: RR
authors.lastname: Henry
authors.forename: Hans
authors.initials: H
authors.lastname: Wedel
authors.forename: Arlette
authors.initials: A
authors.lastname: Weichert
authors.forename: Ruth
authors.initials: R
authors.lastname: Cannata
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000401:mortality / Q000517:prevention & control; D010080:Oxazoles / Q000627:therapeutic use*; D047492:Peroxisome Proliferator-Activated Receptors / Q000819:agonists*; D012307:Risk Factors; D020521:Stroke / Q000401:mortality / Q000517:prevention & control; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D010080:Oxazoles; D047492:Peroxisome Proliferator-Activated Receptors; D013876:Thiophenes; C542437:aleglitazar