Impact of Angiotensin Converting Enzyme Inhibitor versus Angiotensin Receptor Blocker on Incidence of New-Onset Diabetes Mellitus in Asians
Autor: | Raghavender Goud Akkala, Sunki Lee, Yung-Kyun Noh, Jin Oh Na, Ji Young Park, Se Jin Lee, Ji Bak Kim, Seung-Woon Rha, Jae Woong Choi, Se Yeon Choi, Seunghwan Kim, Hong Euy Lim, Cheol Ung Choi, Jin Won Kim, Eung Ju Kim, Hu Li, Jabar Ali, Sung Kee Ryu, Hong Seog Seo, Chang Gyu Park, Dong Joo Oh, Byoung Geol Choi |
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Rok vydání: | 2014 |
Předmět: |
Adult
Blood Glucose Male Angiotensin receptor medicine.medical_specialty Urology 030209 endocrinology & metabolism Angiotensin-Converting Enzyme Inhibitors Kaplan-Meier Estimate 030204 cardiovascular system & hematology 03 medical and health sciences Angiotensin Receptor Antagonists Endocrinology & Metabolism 0302 clinical medicine Asian People Risk Factors Diabetes mellitus Republic of Korea medicine Diabetes Mellitus Humans Cumulative incidence cardiovascular diseases angiotensin receptor blocker Propensity Score Aged Angiotensin II receptor type 1 biology Dose-Response Relationship Drug business.industry Incidence (epidemiology) Incidence Angiotensin-converting enzyme General Medicine Middle Aged medicine.disease Confidence interval Logistic Models Propensity score matching Hypertension Multivariate Analysis biology.protein Female Original Article Angiotensin converting enzyme inhibitor Drug Monitoring business Follow-Up Studies |
Zdroj: | Yonsei Medical Journal |
ISSN: | 1976-2437 |
Popis: | PURPOSE Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) are associated with a decreased incidence of new-onset diabetes mellitus (NODM). The aim of this study was to compare the protective effect of ACEI versus ARBs on NODM in an Asian population. MATERIALS AND METHODS We investigated a total of 2817 patients who did not have diabetes mellitus from January 2004 to September 2009. To adjust for potential confounders, a propensity score matched (PSM) analysis was performed using a logistic regression model. The primary end-point was the cumulative incidence of NODM, which was defined as having a fasting blood glucose ≥126 mg/dL or HbA1c ≥6.5%. Multivariable cox-regression analysis was performed to determine the impact of ACEI versus ARB on the incidence of NODM. RESULTS Mean follow-up duration was 1839±1019 days in all groups before baseline adjustment and 1864±1034 days in the PSM group. After PSM (C-statistics=0.731), a total 1024 patients (ACEI group, n=512 and ARB group, n=512) were enrolled for analysis and baseline characteristics were well balanced. After PSM, the cumulative incidence of NODM at 3 years was lower in the ACEI group than the ARB group (2.1% vs. 5.0%, p=0.012). In multivariate analysis, ACEI vs. ARB was an independent predictor of the lower incidence for NODM (odd ratio 0.37, confidence interval 0.17-0.79, p=0.010). CONCLUSION In the present study, compared with ARB, chronic ACEI administration appeared to be associated with a lower incidence of NODM in a series of Asian cardiovascular patients. |
Databáze: | OpenAIRE |
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