Effect of angiotensin-converting enzyme inhibition on survival in 3773 Chinese type 2 diabetic patients
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AbstractWe assessed the effects of angiotensin-converting enzyme ( ACE) inhibition on survival and cardiorenal outcomes in a consecutive cohort of Chinese type 2 diabetic patients with varying degree of albuminuria, ranging from normoalbuminuria to macroalbuminuria. A total of 3773 consecutive Chinese type 2 diabetic patients were followed prospectively for a mean period of 35.8 months. Clinical end points included all-cause mortality, with cardiovascular end point defined as first hospitalization because of ischemic heart disease, congestive heart failure, revascularization procedures, or cerebrovascular accident as well as renal end point defined as dialysis, doubling of baseline plasma creatinine, or plasma creatinine greater than or equal to 500 mumol/L. The use of ACE inhibitor was 26.3% in normoalbuminuric (NA), 70.1% in microalbuminuric (MI), and 82.6% in macroalbuminuric ( MA) groups. Albuminuria was a major predictor for all-cause mortality with 4-fold difference between NA and MA patients. The 7-year cumulative mortality rate was 7.1%, 10.8%, and 21.7% in the NA, MI, and MA groups, respectively. The use of ACE inhibition was associated with significant reduction of mortality ( hazard ratio 0.41 and 95% confidence interval, 0.29, 0.58) in the entire group and was most evident in high-risk patients who had cardiorenal complications or retinopathy at baseline for all albuminuric groups ( NA 0.76 [ 0.31,1.87]; MI 0.32 [0.16, 0.65]; and MA 0.20 [0.13, 0.33]). The prognostic value of albuminuria for death in type 2 diabetes and the beneficial effects of ACE inhibitors in Chinese type 2 diabetic patients with micro- or macroalbuminuria has been confirmed. The effects of ACE inhibitors in type 2 diabetic patients with normoalbuminuria require further evaluation.
All Author(s) ListSo WY, Ozaki R, Chan NN, Tong PCY, Ho CS, Lam CWK, Ko GTC, Chow CC, Chan WB, Ma RCW, Chan JCN
Journal nameHypertension
Volume Number44
Issue Number3
Pages294 - 299
LanguagesEnglish-United Kingdom
Keywordsangiotensin-converting enzyme; cardiovascular diseases; diabetes mellitus; renal disease
Web of Science Subject CategoriesCardiovascular System & Cardiology; Peripheral Vascular Disease; PERIPHERAL VASCULAR DISEASE

Last updated on 2020-21-10 at 00:21