METHOD AND COMPOUND TO REDUCE THE INCIDENCE OF DIABETES IN ASUBJECT 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 inhibit or 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 .gtoreq. 126 mg/dL (7 mmol/L) wa s found at 2 visits (follow-up, 2.9~1.0 years). Of the 291 non-diabetic patients enroll ed in the SOLVD study, 153 of these were on enalapril and 138 were on placebo. Baseli ne 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 gro up (P<0.0001). By multivariate analysis, enalapril remained the most powerfu l predictor for risk reduction of developing diabetes (hazard ratio, 0.22; 95% confidenc e intervals, 0.10 to 0.46; P<0.0001 ). Enalapril therefore significantly re duces the incidence of diabetes in patients with left ventricular dysfunction, especially those with impaired FPG.