A recently published analysis in Hypertension suggests that thiazide use, versus nonuse, is associated with excess risk of adverse cardiovascular outcomes in patients with diabetes mellitus enrolled in the ACCORD trial (Action to Control Cardiovascular Risk in Diabetes). Here, we replicate these findings using the same publicly available datasets and following their reported methods. We further show that possible misclassification of thiazide exposure exists in the original analysis. We perform alternative analyses that correct for this misclassification to highlight the impact that misclassification can have on observed associations between an exposure (eg, thiazides) and outcomes (eg, stroke and major adverse cardiovascular events).

中文翻译：

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噻嗪类药物暴露与 2 型糖尿病的心血管风险

最近发表在《高血压》杂志上的一项分析表明，在参加 ACCORD 试验（控制糖尿病心血管风险的行动）的糖尿病患者中，使用噻嗪类比不使用噻嗪类药物与不良心血管结局的风险过高有关。在这里，我们使用相同的公开可用数据集并遵循他们报告的方法来复制这些发现。我们进一步表明，原始分析中可能存在对噻嗪类暴露的错误分类。我们执行替代分析来纠正这种错误分类，以强调错误分类可能对观察到的暴露（例如，噻嗪类药物）和结果（例如，中风和主要不良心血管事件）之间的关联产生的影响。