METHOD AND COMPOUND TO REDUCE THE INCIDENCE OF 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 ventriculardysfunction.A retrospective study was conducted to assess the effect of the ACE inhibitorenalapril on the incidence of diabetes in a group of patients from theMontreal HeartInstitute enrolled in the Studies of Left Ventricular Dysfunction (SOLVD).Clinicalcharts were evaluated for fasting plasma glucose (FPG) levels by blindedreviewers.A diagnosis of diabetes was made when a FPG = 126 mg/dL (7 mmol/L) wasfound at2 visits (follow-up, 2.9~1.0 years). Of the 291 non-diabetic patients enrolledin theSOLVD study, 153 of these were on enalapril and 138 were on placebo. Baselinecharacteristics were similar in the 2 groups. Forty patients developeddiabetes duringfollow-up, 9 (5.9%) in the enalapril group and 31 (22.4%) in the placebo group(P0.0001). By multivariate analysis, enalapril remained the most powerfulpredictorfor risk reduction of developing diabetes (hazard ratio, 0.22; 95% confidenceintervals, 0.10 to 0.46; P0.0001 ). Enalapril therefore significantly reducestheincidence of diabetes in patients with left ventricular dysfunction,especially those withimpaired FPG.