title: Myocardial Injury without Electrocardiographic Changes after a Suicide Attempt by an Overdose of Glimepiride and Zolpidem: A Case Report and Literature Review.
abstract: A 40-year-old diabetic man was admitted to our hospital for poor glycemic control. During hospitalization, he took 42 mg glimepiride and 50 mg zolpidem as a suicide attempt. The following day, the creatine kinase-MB fraction and troponin I levels were elevated to 112 IU/L and 8.77 ng/mL, respectively, without any electrocardiographic abnormalities. The patient recovered completely without any complications. Four weeks later, coronary computed tomography angiography and myocardial perfusion scintigraphy revealed moderate one-vessel coronary disease without the evidence of myocardial ischemia or old infarction. Cardiac-specific markers must be considered in sulfonylurea-induced hypoglycemic patients, particularly when the patient is unconscious and does not exhibit any clinical manifestations.
authors.affiliation: Department of Endocrinology and Metabolism, JCHO Tokyo Shinjuku Medical Center, Japan.
authors.forename: Shengpu
authors.initials: S
authors.lastname: Chou
authors.forename: Seiji
authors.initials: S
authors.lastname: Ayabe
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sekine
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D062787:Drug Overdose / Q000150:complications*; D058785:GABA-A Receptor Agonists / Q000506:poisoning*; D006335:Heart Injuries / Q000139:chemically induced* / Q000150:complications; D006801:Humans; D007004:Hypoglycemic Agents / Q000506:poisoning*; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood / Q000139:chemically induced* / Q000150:complications; D011725:Pyridines / Q000506:poisoning*; D013406:Suicide, Attempted; D013453:Sulfonylurea Compounds / Q000506:poisoning*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood; D000077334:Zolpidem
chemical_list: D015415:Biomarkers; D058785:GABA-A Receptor Agonists; D007004:Hypoglycemic Agents; D011725:Pyridines; D013453:Sulfonylurea Compounds; D020107:Troponin T; C057619:glimepiride; D000077334:Zolpidem; D052279:Creatine Kinase, MB Form