Sulfonylurea drugs do not influence initial stroke severity and in-hospital outcome in stroke patients with diabetes.
OBJECTIVE
Sulfonylurea drugs inhibit ATP-dependent potassium channels and may increase mortality after myocardial infarction. Sulfonylurea drugs also inhibit ischemic preconditioning in experimental models of brain ischemia and in clinical studies in the human heart.


METHODS
In the present study we examined the impact of sulfonylurea drugs on in-hospital mortality and the immediate neurological deficit of diabetic stroke patients. From a larger stroke data bank, we studied 146 diabetic patients with acute hemispheric ischemic stroke. Sixty patients were using sulfonylurea drugs.


RESULTS
Major baseline characteristics such as age, blood pressure, admission glucose level, HbA(1c), distribution of cardiovascular risk factors, and presumed stroke etiology (Trial of Org 10172 in Acute Stroke Treatment [TOAST] criteria) were not different. Mortality (15% versus 14%; P=0.86) and initial stroke severity (Canadian Neurological Scale score, 7.4 versus 7.5; P=0.79) were not significantly different between patients with and without sulfonylurea drugs. Further end points such as Rankin Scale score, deteriorating stroke, duration of hospital stay, type of infarcts on CT/MRI, requirement of intensive care, and complications were not different. In a stepwise logistic regression model, sulfonylurea drugs were not independent predictors for increased mortality, deteriorating stroke, or stroke severity.


CONCLUSIONS
In the present hospital-based study, sulfonylurea drugs in patients with diabetes and stroke are not associated with increased stroke severity, mortality, or a worse in-hospital outcome.
Weih
M
M
Department of Neurology, Charite Hospital, Humboldt University Berlin, Germany.
Amberger
N
N
Wegener
S
S
Dirnagl
U
U
Reuter
T
T
Einhäupl
K
K
D000368:Aged; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000401:mortality*; D018450:Disease Progression; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D019194:Ischemic Preconditioning; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000401:mortality* / Q000628:therapy; D013453:Sulfonylurea Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
D007328:Insulin; D013453:Sulfonylurea Compounds