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Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease
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...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171952/ https://www.ncbi.nlm.nih.gov/pubmed/32144166 http://dx.doi.org/10.2337/dc19-2204 |
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author | Schwartz, Gregory G. Leiter, Lawrence A. Ballantyne, Christie M. Barter, Philip J. Black, Donald M. Kallend, David Laghrissi-Thode, Fouzia Leitersdorf, Eran McMurray, John J.V. Nicholls, Stephen J. Olsson, Anders G. Preiss, David Shah, Prediman K. Tardif, Jean-Claude Kittelson, John |
author_facet | Schwartz, Gregory G. Leiter, Lawrence A. Ballantyne, Christie M. Barter, Philip J. Black, Donald M. Kallend, David Laghrissi-Thode, Fouzia Leitersdorf, Eran McMurray, John J.V. Nicholls, Stephen J. Olsson, Anders G. Preiss, David Shah, Prediman K. Tardif, Jean-Claude Kittelson, John |
author_sort | Schwartz, Gregory G. |
collection | PubMed |
description | 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. 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(1c) 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(1c) ≥6.5%, or a combination of at least two measurements of serum glucose ≥7.0 mmol/L (fasting) or ≥11.1 mmol/L (random). 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. CONCLUSIONS: In patients with a recent acute coronary syndrome, incident diabetes is common and is reduced substantially by treatment with dalcetrapib. |
format | Online Article Text |
id | pubmed-7171952 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-71719522020-05-06 Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease Schwartz, Gregory G. Leiter, Lawrence A. Ballantyne, Christie M. Barter, Philip J. Black, Donald M. Kallend, David Laghrissi-Thode, Fouzia Leitersdorf, Eran McMurray, John J.V. Nicholls, Stephen J. Olsson, Anders G. Preiss, David Shah, Prediman K. Tardif, Jean-Claude Kittelson, John Diabetes Care Emerging Therapies: Drugs and Regimens 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. 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(1c) 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(1c) ≥6.5%, or a combination of at least two measurements of serum glucose ≥7.0 mmol/L (fasting) or ≥11.1 mmol/L (random). 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. CONCLUSIONS: In patients with a recent acute coronary syndrome, incident diabetes is common and is reduced substantially by treatment with dalcetrapib. American Diabetes Association 2020-05 2020-03-06 /pmc/articles/PMC7171952/ /pubmed/32144166 http://dx.doi.org/10.2337/dc19-2204 Text en © 2020 by the American Diabetes Association Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at https://www.diabetesjournals.org/content/license. |
spellingShingle | Emerging Therapies: Drugs and Regimens Schwartz, Gregory G. Leiter, Lawrence A. Ballantyne, Christie M. Barter, Philip J. Black, Donald M. Kallend, David Laghrissi-Thode, Fouzia Leitersdorf, Eran McMurray, John J.V. Nicholls, Stephen J. Olsson, Anders G. Preiss, David Shah, Prediman K. Tardif, Jean-Claude Kittelson, John Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease |
title | Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease |
title_full | Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease |
title_fullStr | Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease |
title_full_unstemmed | Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease |
title_short | Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease |
title_sort | dalcetrapib reduces risk of new-onset diabetes in patients with coronary heart disease |
topic | Emerging Therapies: Drugs and Regimens |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171952/ https://www.ncbi.nlm.nih.gov/pubmed/32144166 http://dx.doi.org/10.2337/dc19-2204 |
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