title: Myocardial infarction in diabetic vs non-diabetic subjects. Survival and infarct size following therapy with sulfonylureas (glibenclamide)
abstract: OBJECTIVE
  Sulfonylureas may interfere with 'ischaemic preconditioning' and worsen the prognosis in diabetic patients with acute myocardial infarction.
  
  
  RESULTS
  Three hundred and fifty-seven non-diabetic patients admitted with acute myocardial infarction to one hospital over 6.5 years (72 deaths, in-hospital mortality 20.2%) were compared to 245 Type 2 diabetic patients categorized as having taken sulfonylureas (glibenclamide 7+/-3 mg x day(-1); n = 76, 25 deaths = 32.9%;P = 0.025), not having taken sulfonylureas (n = 89, 29 deaths = 33.0%;P = 0.012), and newly diagnosed as having diabetes (n = 80, 20 deaths = 25.0%). Survival was significantly different (log-rank test: P = 0.03). Increments in creatine kinase and creatine kinase(MB)activity were higher in non-diabetic patients (P<0.01).
  
  
  CONCLUSIONS
  In-hospital mortality in Type 2 diabetic patients is higher than in non-diabetic patients suffering acute myocardial infarction regardless of whether or not they had been treated with sulfonylureas. Glibenclamide does not enlarge myocardial necroses.
authors.affiliation: Department of Medicine, Ruhr-University Knappschafts-Krankenhaus, Bochum, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Klamann
authors.forename: P
authors.initials: P
authors.lastname: Sarfert
authors.forename: V
authors.initials: V
authors.lastname: Launhardt
authors.forename: G
authors.initials: G
authors.lastname: Schulte
authors.forename: W H
authors.initials: WH
authors.lastname: Schmiegel
authors.forename: M A
authors.initials: MA
authors.lastname: Nauck
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003402:Creatine Kinase / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D003925:Diabetic Angiopathies / Q000401:mortality*; D005260:Female; D005905:Glyburide / Q000627:therapeutic use*; D017052:Hospital Mortality; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality*; D016019:Survival Analysis
chemical_list: D007004:Hypoglycemic Agents; D003402:Creatine Kinase; D005905:Glyburide