No Association between CCBs, Diabetes Mellitus Found in Asian Patients with CVD
SAN FRANCISCO, CA—A study of more than 4,000 patients found no clear association between calcium channel blocker (CCB) therapy and new-onset diabetes in an Asian population with cardiovascular disease, a study to explore this controversy concluded at ACC.13, the American College of Cardiology's 62nd Annual Scientific Session.
Seung-Woon Rha, MD, PhD, of the Cardiovascular Center at the Korea University Guro Hospital in Seoul, South Korea, and colleagues investigated the association between CCBs and new-onset diabetes mellitus among 4,231 patients who had HbA1C <6.0% and a fasting glucose <100 mg/dL. A total of 2,229 patients were enrolled in the CCB arm and 2,002 patients in the control arm. “To adjust confounders, a propensity score matched analysis (CCB group=1,724 and control group=1,724) was performed using the logistic regression model,” Dr. Rha reported.
Primary end-point was cumulative incidence of new-onset diabetes mellitus, defined as an HbA1C >6.5% or a fasting glucose >126mg/dL). Multivariable Cox-regression analysis was performed to determine the impact of CCB therapy on the incidence of new-onset diabetes mellitus. After univariate analyses, baseline confounding factors and medical treatment history were entered into the multivariable Cox regression analysis to determine the impact of chronic beta blocker therapy on development of new-onset DM.
For all patients, mean follow-up duration was 908 ± 558 days and 905 ± 559 days in the propensity score matched group. Baseline characteristics were similar between the two groups; however, more patients had hypertension in the CCB group, 58.6% (n=1,011) vs 55.1% (n=950), respectively (P=0.036).
No difference between the two groups was found after propensity score matching and Kaplan-Meier analysis (P=0.486). Cox-regression analysis, performed in all patients, found treatment with CCB was not associated with increased incidence of new-onset diabetes mellitus (P=0.708; OR 1.067 [95% CI 0.759-1.500]).Dr. Rha and colleagues were able to conclude that “there was no clear association with CCB therapy and new-onset diabetes mellitus inn a series of cardiovascular patients in the Asian population.”