期刊
EUROPEAN HEART JOURNAL
卷 21, 期 3, 页码 220-229出版社
W B SAUNDERS CO LTD
DOI: 10.1053/euhj.1999.1999
关键词
sulfonylureas; ischemic preconditioning; myocardial infarction; mortality; Type 2 diabetes
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 . 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. (C) 2000 The European Society of Cardiology.
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