Myocardial infarction in diabetic vs non-diabetic subjects. Survival and infarct size following therapy with sulfonylureas (glibenclamide) |
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Authors: | A Klamann P Sarfert V Launhardt G Schulte W H Schmiegel M A Nauck |
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Affiliation: | Department of Medicine, Ruhr-University Knappschafts-Krankenhaus, Bochum, Germany. |
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Abstract: | AIMS: Sulfonylureas may interfere with 'ischaemic preconditioning' and worsen the prognosis in diabetic patients with acute myocardial infarction. METHODS AND RESULTS: Three hundred and fifty-seven non-diabetic patients admitted with acute myocardial infarction to one hospital over 6.5 years (72 deaths, in-hospital mortality 20.2%) were compared to 245 Type 2 diabetic patients categorized as having taken sulfonylureas (glibenclamide 7+/-3 mg x day(-1); n = 76, 25 deaths = 32.9%;P = 0.025), not having taken sulfonylureas (n = 89, 29 deaths = 33.0%;P = 0.012), and newly diagnosed as having diabetes (n = 80, 20 deaths = 25.0%). Survival was significantly different (log-rank test: P = 0.03). Increments in creatine kinase and creatine kinase(MB)activity were higher in non-diabetic patients (P<0.01). CONCLUSIONS: In-hospital mortality in Type 2 diabetic patients is higher than in non-diabetic patients suffering acute myocardial infarction regardless of whether or not they had been treated with sulfonylureas. Glibenclamide does not enlarge myocardial necroses. |
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Keywords: | Sulfonylureas ischemic preconditioning myocardial infarction mortality Type 2 diabetes |
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