Back to Search
Start Over
Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease.
- Source :
-
Diabetes care [Diabetes Care] 2020 May; Vol. 43 (5), pp. 1077-1084. Date of Electronic Publication: 2020 Mar 06. - Publication Year :
- 2020
-
Abstract
- Objective: Incident type 2 diabetes is common among patients with recent acute coronary syndrome and is associated with an adverse prognosis. Some data suggest that cholesteryl ester transfer protein (CETP) inhibitors reduce incident type 2 diabetes. We compared the effect of treatment with the CETP inhibitor dalcetrapib or placebo on incident diabetes in patients with recent acute coronary syndrome.<br />Research Design and Methods: In the dal-OUTCOMES trial, 15,871 patients were randomly assigned to treatment with dalcetrapib 600 mg daily or placebo, beginning 4-12 weeks after an acute coronary syndrome. Absence of diabetes at baseline was based on medical history, no use of antihyperglycemic medication, and hemoglobin A <subscript>1c</subscript> and serum glucose levels below diagnostic thresholds. Among these patients, incident diabetes after randomization was defined by any diabetes-related adverse event, new use of antihyperglycemic medication, hemoglobin A <subscript>1c</subscript> ≥6.5%, or a combination of at least two measurements of serum glucose ≥7.0 mmol/L (fasting) or ≥11.1 mmol/L (random).<br />Results: At baseline, 10,645 patients (67% of the trial cohort) did not have diabetes. During a median follow-up of 30 months, incident diabetes was identified in 403 of 5,326 patients (7.6%) assigned to dalcetrapib and in 516 of 5,319 (9.7%) assigned to placebo, corresponding to absolute risk reduction of 2.1%, hazard ratio of 0.77 (95% CI 0.68-0.88; P < 0.001), and a need to treat 40 patients for 3 years to prevent 1 incident case of diabetes. Considering only those with prediabetes at baseline, the number needed to treat for 3 years to prevent 1 incident case of diabetes was 25. Dalcetrapib also decreased the number of patients who progressed from normoglycemia to prediabetes and increased the number who regressed from diabetes to no diabetes.<br />Conclusions: In patients with a recent acute coronary syndrome, incident diabetes is common and is reduced substantially by treatment with dalcetrapib.<br /> (© 2020 by the American Diabetes Association.)
- Subjects :
- Acute Coronary Syndrome complications
Acute Coronary Syndrome drug therapy
Acute Coronary Syndrome epidemiology
Aged
Anticholesteremic Agents therapeutic use
Blood Glucose drug effects
Blood Glucose metabolism
Cohort Studies
Coronary Disease complications
Coronary Disease epidemiology
Diabetes Mellitus, Type 2 epidemiology
Female
Humans
Incidence
Male
Middle Aged
Prediabetic State complications
Prediabetic State drug therapy
Prediabetic State epidemiology
Prediabetic State pathology
Risk Factors
Risk Reduction Behavior
Amides therapeutic use
Coronary Disease drug therapy
Diabetes Mellitus, Type 2 prevention & control
Esters therapeutic use
Sulfhydryl Compounds therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1935-5548
- Volume :
- 43
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 32144166
- Full Text :
- https://doi.org/10.2337/dc19-2204