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Purpose: Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) are associated with a decreasedincidence of new-onset diabetes mellitus (NODM). The aim of this study was to compare the protective effect of ACEIversus ARBs on NODM in an Asian population. Materials and Methods: We investigated a total of 2817 patients who did not have diabetes mellitus from January 2004 to September2009. To adjust for potential confounders, a propensity score matched (PSM) analysis was performed using a logistic regressionmodel. The primary end-point was the cumulative incidence of NODM, which was defined as having a fasting bloodglucose ≥126 mg/dL or HbA1c ≥6.5%. Multivariable cox-regression analysis was performed to determine the impact of ACEI versusARB on the incidence of NODM. Results: Mean follow-up duration was 1839±1019 days in all groups before baseline adjustment and 1864±1034 days in the PSMgroup. After PSM (C-statistics=0.731), a total 1024 patients (ACEI group, n=512 and ARB group, n=512) were enrolled for analysisand baseline characteristics were well balanced. After PSM, the cumulative incidence of NODM at 3 years was lower in the ACEIgroup than the ARB group (2.1% vs. 5.0%, p=0.012). In multivariate analysis, ACEI vs. ARB was an independent predictor of thelower incidence for NODM (odd ratio 0.37, confidence interval 0.17–0.79, p=0.010). Conclusion: In the present study, compared with ARB, chronic ACEI administration appeared to be associated with a lower incidenceof NODM in a series of Asian cardiovascular patients.
