USE OF ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITORS TO PREVENT DIABETES IN A SUBJECT WITH CHRONIC HEART FAILURE

摘要

The present invention relates to the effect of angiotensin-converting enzyme (ACE) inhibitors on the prevention of diabetes in a subject with left ventricular dysfunction. A retrospective study was conducted to assess the effect of the ACE inhibitor enalapril on the incidence of diabetes in a group of patients from the Montreal Heart Institute enrolled in the Studies of Left Ventricular Dysfunction (SOLVD). Clinical charts were evaluated for fasting plasma glucose (FPG) levels by blinded reviewers. A diagnosis of diabetes was made when a FPG 126 mg/dL (7 mmol/L) was found at 2 visits (follow-up, 2.9±1.0 years). Of the 291 non-diabetic patients enrolled in the SOLVD study, 153 of these were on enalapril and 138 were on placebo. Baseline characteristics were similar in the 2 groups. Forty patients developed diabetes during follow-up, 9 (5.9%) in the enalapril group and 31(22.4%) in the placebo group (P<0.0001). By multivariate analysis, enalapril remained the most powerful predictor for risk reduction of developing diabetes (hazard ratio, 0.22; 95% confidence intervals, 0.10 to 0.46; P<0.0001). Enalapril therefore significantly reduces the incidence of diabetes in patients with left ventricular dysfunction, especially those with impaired FPG.