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
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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