Impact of Angiotensin Converting Enzyme Inhibitor versus Angiotensin Receptor Blocker on Incidence of New-Onset Diabetes Mellitus in Asians
Yonsei Medical Journal 2016³â 57±Ç 1È£ p.180 ~ p.186
¹ÚÁö¿µ(Park Ji-Young) - Eulji University College of Medicine Eulji General Hospital Department of Cardiology
³ª½Â¿î(Rha Seung-Woon) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
ÃÖº´°É(Choi Byoung-Geol) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
(Choi Se-Yeon) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
ÃÖÀç¿õ(Choi Jae-Woong) - Eulji University College of Medicine Eulji General Hospital Department of Cardiology
À¯½Â±â(Ryu Sung-Kee) - Eulji University College of Medicine Eulji General Hospital Department of Cardiology
À̼¼Áø(Lee Se-Jin) - Eulji University College of Medicine Eulji General Hospital Department of Cardiology
±Ý¼ºÈ¯(Kim Seung-Hwan) - Eulji University College of Medicine Eulji General Hospital Department of Cardiology
³ë¿µ±Õ(Noh Yung-Kyun) - Korea Advanced Institute of Science and Technology Department of Computer Science
(Akkala Raghavender Goud) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
(Li Hu) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
(Ali Jabar) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
±èÁö¹Ú(Kim Ji-Bak) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
À̼±±â(Lee Sun-Ki) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
³ªÁø¿À(Na Jin-Oh) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
ÃÖö¿õ(Choi Cheol-Ung) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
ÀÓÈ«ÀÇ(Lim Hong-Euy) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
±èÁø¿ø(Kim Jin-Won) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
±èÀÀÁÖ(Kim Eung-Ju) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
¹Úâ±Ô(Park Chang-Gyu) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
¼È«¼®(Seo Hong-Seog) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
¿Àµ¿ÁØ(Oh Dong-Joo) - Korea University College of Medicine Korea University Guro Hospital Cardiovascular Center
Abstract
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 ¡Ã126 mg/dL or HbA1c ¡Ã6.5%. 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¡¾1019 days in all groups before baseline adjustment and 1864¡¾1034 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.
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Angiotensin converting enzyme inhibitor, angiotensin receptor blocker, diabetes mellitus
KMID :
0311120160570010180
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À¯È¿¼º°á°ú(Recomendation)
The cumulative incidence of NODM up to 3 years was lower in the ACEI group than the AEB group.; Comparing with ARB, chronic ACEI administration appeared to be associated with a lower incidence of NODM in a series of Asian cardiovascular patients.