Abstract
Introduction
Patients with type 2 diabetes show a significantly higher mortality after acute myocardial
infarction than non-diabetic patients. The influence of sulfonylureas on the survival
after acute myocardial infarction is still under debate.
Patients and Methods
Survival of 562 patients, consecutively admitted to an intensive care unit with the
diagnosis acute myocardial infarction, was prospectively assessed for > 3 years. At
the time of hospital admission, patients were grouped as (a) non-diabetic patients;
(b) patients with newly diagnosed type 2 diabetes; (c) patients with known type 2
diabetes not treated with sulfonylureas and (d) patients with known type 2 diabetes
treated with sulfonylureas. Survival-analysis was performed according to Kaplan-Meier.
Results
324 patients were non-diabetics, in 86 cases type 2 diabetes was newly diagnosed at
the time of hospital admission, 77 patients with known diabetes had taken sulfonylureas
(glibenclamide in all cases) prior to the acute myocardial infarction, 75 patients
were on any other antidiabetic treatment. Long-term-survival was significantly shorter
in patients with type 2 diabetes compared to the non-diabetic patients (p < 0.0001).
However, no significant differences were observed between the patients with type 2
diabetes treated with sulfonylurea-drugs and those receiving any other antidiabetic
treatment (p = 0.53)
Conclusions
An antidiabetic treatment with sulfonylurea-drugs prior to acute myocardial infarction
does not have negative effects on the long-term survival. Larger prospective studies
will be necessary to finally clarify this question.
Key words
Type 2 diabetes - sulfonylureas - myocardial infarction - ischemic preconditioning
References
Sulfonylureas: basic aspects and clinical use. Alberti KGMM, Zimmet P, DeFronzo RA, Keen H International Textbook of Diabetes Mellitus.
Vol. 1. Chichester, UK; John Wiley & Sons Ltd 1997: 817-840
m.nauck@diabeteszentrum.de
