biostudies-literatureSchwartz GGBritish Heart FoundationAmerican Heart Association-American Stroke AssociationNHLBI NIH HHS1077-1084https://www.ebi.ac.uk/biostudies/studies/S-EPMC7171952biostudies-literatureUnknown43(5)<h4>Objective</h4>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.<h4>Research design and methods</h4>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).<h4>Results</h4>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; <i>P</i> < 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.<h4>Conclusions</h4>In patients with a recent acute coronary syndrome, incident diabetes is common and is reduced substantially by treatment with dalcetrapib.Diabetes careDalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease.PMC7171952RE/13/1/30181R01 HL134320R01 HL09883916GRNT30410012Kallend DMcMurray JJVKittelson JBallantyne CMLaghrissi-Thode FSchwartz GGLeiter LAPreiss DBlack DMNicholls SJTardif JCShah PKBarter PJLeitersdorf EOlsson AGfalseDalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease.<h4>Objective</h4>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.<h4>Research design and methods</h4>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).<h4>Results</h4>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; <i>P</i> < 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.<h4>Conclusions</h4>In patients with a recent acute coronary syndrome, incident diabetes is common and is reduced substantially by treatment with dalcetrapib.2020-01-01T00:00:00Z2020 May2021-02-21T01:03:24Z2020-05-22T19:18:56ZS-EPMC71719523214416610.2337/dc19-2204