Document Detail


Sulfonylurea derivatives in cardiovascular research and in cardiovascular patients.
MedLine Citation:
PMID:  9217875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sulfonylurea derivatives are hypoglycemic drugs frequently used in the treatment of non-insulin-dependent diabetes mellitus (NIDDM). In the beta-cell sulfonylureas act by blocking ATP-sensitive potassium channels (K.ATP channels). In several organ systems, including the cardiovascular system, sulfonylurea receptors and functional K.ATP channels have been identified. In the heart their role is not clear: an endogenous cardioprotective effect has been suggested. There is no doubt that K.ATP channels are effectively blocked by sulfonylureas. In the last decade sulfonylureas have been widely used as a pharmacological tool in experimental (cardiac) research. Blockade of K.ATP channels is the proposed cellular mechanism of action for all sulfonylurea-related effects. However, other membrane currents are affected as well. In addition, myocardial metabolism is modified by sulfonylurea pretreatment. Hence, it should seriously be questioned whether these drugs are suitable in assessing involvement of cardiac K.ATP channels in, for example, ischemia-related events. The detrimental effects of sulfonylureas in experimental studies on myocardial ischemia have led to speculation whether the widespread use of these drugs in patients with NIDDM, most often suffering from accompanying ischemic heart disease, should be reconsidered. However, a review of the clinical literature reveals that the most consistent finding is a lower incidence of ventricular arrhythmias associated with the use of glibenclamide, while no excess mortality has been shown for this agent in NIDDM with ischemic heart disease. Despite some direct effects on systemic and coronary vasculature, there are, at present, no firm clinical data on the basis of which sulfonylurea derivatives should be withheld from the cardiac patient.
Authors:
C E Schotborgh; A A Wilde
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Cardiovascular research     Volume:  34     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-08-11     Completed Date:  1997-08-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  73-80     Citation Subset:  IM    
Affiliation:
Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Animals
Arrhythmias, Cardiac / drug therapy,  metabolism
Diabetes Mellitus, Type 2 / drug therapy,  metabolism*
Humans
Hypoglycemic Agents / adverse effects,  pharmacology*
Myocardial Infarction / drug therapy,  metabolism
Myocardial Ischemia / drug therapy,  metabolism*
Myocardium / metabolism*
Potassium Channels / drug effects*
Sulfonylurea Compounds / adverse effects,  pharmacology*
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Potassium Channels; 0/Sulfonylurea Compounds

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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