MI outcomes for diabetic patients unaffected by prior sulfonylurea use
MedWire News: French researchers suggest that diabetic patients using sulfonylureas (SUs) before an acute myocardial infarction (MI) do not have worse early outcomes than those with no prior use of the drug.
"The in-hospital outcome of patients on chronic SU therapy is, if anything, better than that of patients without such treatment," say Marianne Zeller, from Institut Fédératif de Recherche Santé-Sciences et Techniques de l'Information de la Communication in Dijon, and colleagues.
Zeller et al analyzed the outcomes and drug histories of 1310 MI patients with diabetes as recorded in the French Registry of Acute ST-Elevation and Non-ST-Elevation MI in 2005.
They found that patients previously treated with SUs (n=459) had a lower in-hospital mortality rate than those taking other oral antidiabetics (n=295), insulin (n=341), or no antidiabetic medication at all (n=215), at 3.9% versus 6.4%, 9.4%, and 8.4%, respectively.
In addition, patients taking pancreatic cell-specific SUs such as gliclazide or glimepiride had a lower in-hospital mortality rate than those taking glibenclamide, at 2.7% versus 7.5%, respectively.
Of note, other complications such as arrhythmias were also less common among patients taking pancreatic-cell specific SUs than glibenclamide, a result that persisted even after multivariate adjustment.
The researchers say that this finding "strengthens the case that all SUs do not have the same impact on cardiac outcomes and should therefore not be considered a single pharmacologic entity."
They conclude: "Further studies are needed to investigate whether ischemic preconditioning plays a truly relevant beneficial effect at the acute stage of MI, as our findings with an SU known to block preconditioning mechanisms might suggest."
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By Lauretta Ihonor