| Sulfonylurea drugs increase early mortality in patients with diabetes mellitus after direct angioplasty for acute myocardial infarction. | |
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MedLine Citation:
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PMID: 9935017 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to examine the impact of sulfonylurea drug use on outcome in diabetic patients undergoing direct coronary angioplasty for acute myocardial infarction. BACKGROUND: Sulfonylurea drugs impair ischemic preconditioning. Whether sulfonylurea drugs affect outcome adversely in diabetic patients undergoing direct angioplasty for acute myocardial infarction is unknown. METHODS: Clinical outcomes after direct balloon angioplasty for acute myocardial infarction were evaluated in 67 diabetic patients taking oral sulfonylurea drugs and 118 diabetic patients not taking these drugs. RESULTS: Hospital mortality was significantly higher among diabetics treated with sulfonylurea drugs at the time of myocardial infarction (24% vs. 11%). Univariate analysis identified sulfonylurea drug, age, ventricular function, ejection fraction less than 40%, prior bypass surgery and congestive heart failure as correlates of increased in-hospital mortality. Logistic regression found sulfonylurea drug use (odds ratio 2.77, p=0.017) to be independently associated with early mortality. Congestive heart failure, but not sulfonylurea drug use, was associated with an increased incidence of in-hospital ventricular arrhythmias. Congestive heart failure, prior bypass surgery and female gender, but not sulfonylurea drug use, were associated with late adverse events. CONCLUSIONS: Sulfonylurea drug use is associated with an increased risk of in-hospital mortality among diabetic patients undergoing coronary angioplasty for acute myocardial infarction. This early risk is not explained by an increase in ventricular arrhythmias, but may reflect deleterious effects of sulfonylurea drugs on myocardial tolerance for ischemia and reperfusion. For surviving patients sulfonylurea drug use is not associated with an increased risk of serious late adverse events. |
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Authors:
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K N Garratt; P A Brady; N L Hassinger; D E Grill; A Terzic; D R Holmes |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 33 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1999 Jan |
Date Detail:
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Created Date: 1999-02-17 Completed Date: 1999-02-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 119-24 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angioplasty, Transluminal, Percutaneous Coronary* Diabetes Mellitus, Type 2 / mortality*, therapy Diabetic Angiopathies / mortality*, therapy Female Follow-Up Studies Hemodynamics / drug effects Hospital Mortality* Humans Hypoglycemic Agents / administration & dosage, adverse effects* Male Middle Aged Myocardial Infarction / mortality*, therapy Odds Ratio Regression Analysis Risk Sulfonylurea Compounds / administration & dosage, adverse effects* Survival Rate Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Hypoglycemic Agents; 0/Sulfonylurea Compounds |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 1999 Sep;34(3):958
[PMID:
10483986
]
J Am Coll Cardiol. 2000 Mar 1;35(3):820-1 [PMID: 10716492 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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