Enalapril Reduces the Incidence of Diabetes in Patients With Chronic Heart Failure
Key result
Enalapril significantly reduced the incidence of diabetes compared to placebo in patients with left ventricular dysfunction (5.9% vs 22.4%; HR 0.22; 95% CI 0.10-0.46; P<0.0001).
Why the study?
Does enalapril reduce the incidence of diabetes in non-diabetic patients with left ventricular dysfunction?
Population
291 non-diabetic patients with left ventricular dysfunction from the Montreal Heart Institute enrolled in…
Comparison
Enalapril vs Placebo
Design
Cohort, Clinical charts evaluated by blinded reviewers
Follow-up
2.9+/-1.0 years
Authors
Discussion
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Implication
May support diabetes prevention with enalapril in LV dysfunction; hypothesis-generating from observational data and requires RCT confirmation.
Key Points
- To evaluate the effect of enalapril on the incidence of diabetes in patients with chronic heart failure.
- Retrospective chart review of 391 patients with left ventricular dysfunction.
- Assessment based on fasting plasma glucose levels measured at two visits.
- Follow-up duration averaged 2.9 years.
- In the enalapril group, 5.9% developed diabetes compared to 22.4% in the placebo group (P<0.0001).
- Enalapril showed a hazard ratio of 0.22 for diabetes risk reduction (95% CI 0.10 to 0.46; P<0.0001).
- In patients with impaired fasting glucose, only 3.3% on enalapril developed diabetes versus 48.0% on placebo (P<0.0001).
Study Design
Type
Cohort (n=291)
Blinding
Blinded reviewers
Multicenter
No
Structured PICO
Does enalapril reduce the incidence of diabetes in non-diabetic patients with left ventricular dysfunction?
P
Population
291 non-diabetic patients with left ventricular dysfunction (chronic heart failure) from the Montreal Heart Institute enrolled in the SOLVD trial
I
Intervention
Enalapril
C
Comparator
Placebo
O
Outcome
Incidence of diabetes (fasting plasma glucose ≥126 mg/dL at 2 visits)hard clinical
Main Result
Effect estimate: HR 0.22 (95% CI 0.10-0.46)
Absolute Event Rate: 5.9% vs 22.4%
p-value: p=<0.0001
Enalapril significantly reduces the incidence of new-onset diabetes in patients with left ventricular dysfunction, particularly those with impaired fasting glucose at baseline.
Cite This Study
Vermès et al. (2003) conducted a cohort in Chronic Heart Failure with left ventricular dysfunction (n=291). Enalapril vs. Placebo was evaluated on Incidence of diabetes (fasting plasma glucose >=126 mg/dL at 2 visits) (HR 0.22, 95% CI 0.10-0.46, p=<0.0001). Enalapril significantly reduced the incidence of diabetes compared to placebo in patients with left ventricular dysfunction (5.9% vs 22.4%; HR 0.22; 95% CI 0.10-0.46; P<0.0001).