Document Detail

Effects of glibenclamide, a K(ATP) channel blocker, on warm-up phenomenon in type II diabetic patients with chronic stable angina pectoris.
MedLine Citation:
PMID:  10894443     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Warm-up phenomenon, one of the clinical models of ischemic preconditioning, refers to an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. HYPOTHESIS: Blockers of K(ATP) channels, such as the sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of glibenclamide, a sulfonylurea with a high affinity for myocardial K(ATP) channels, on the results of two consecutive exercise tests in diabetic patients with coronary artery disease. METHODS: Eighteen type II diabetic patients with chronic stable angina pectoris participated in this study. All patients underwent two consecutive treadmill exercise tests with a recovery period of 15 min in fasting state. On the day after these exercise tests, 10 mg oral glibenclamide was given to the same patients and 30 min later 200 ml of 30% glucose solution was given orally. Half an hour later, which is the time of peak plasma levels of glibenclamide, two exercise tests were repeated consecutively with a 15 min recovery period. RESULTS: There was no difference in blood glucose levels before and after exercise tests on each day (p > 0.05). Without glibenclamide, heart rate, rate-pressure product at 1.5 mm ST depression, and peak exercise increased significantly (p < 0.05). Time to 1.5 mm ST-segment depression and onset of pain, as well as duration of exercise also increased, but ST-segment depression and ST-recovery time significantly decreased (p < 0.05). In contrast, these values did not significantly change after glibenclamide (p>0.05), with a significant drug-test interaction (p < 0.05, at two-way ANOVA). CONCLUSIONS: Glibenclamide, an oral hypoglycemic agent with a K(ATP) channel-blocker activity, with a 10 mg oral dose, abolished the warm-up phenomenon which is a clinical finding of ischemic preconditioning on two consecutive exercise tests. Therefore, glibenclamide should be used carefully in patients with coronary heart disease and diabetes mellitus since this agent leads to a decrease in ischemic threshold and exercise capacity.
K Ovünç
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  23     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-10-18     Completed Date:  2000-11-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  535-9     Citation Subset:  IM    
Hacettepe University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey.
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MeSH Terms
Adenosine Triphosphatases / antagonists & inhibitors*,  blood
Adenosine Triphosphate / blood
Administration, Oral
Angina Pectoris / blood,  complications,  radiography,  therapy*
Blood Pressure / drug effects
Cation Transport Proteins
Chronic Disease
Coronary Angiography
Diabetes Mellitus, Type 2 / blood,  complications,  drug therapy*
Electrocardiography / drug effects
Exercise Test
Glyburide / administration & dosage*
Heart Rate / drug effects
Hypoglycemic Agents / administration & dosage*
Ischemic Preconditioning, Myocardial* / methods
Middle Aged
Potassium Channels / blood,  drug effects
Reg. No./Substance:
0/Cation Transport Proteins; 0/Hypoglycemic Agents; 0/Potassium Channels; 10238-21-8/Glyburide; 56-65-5/Adenosine Triphosphate; EC 3.6.1.-/Adenosine Triphosphatases; EC 3.6.1.-/potassium transporting ATPase

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