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Exp Clin Endocrinol Diabetes 2003; 111(6): 344-350
DOI: 10.1055/s-2003-42725
Article

J. A. Barth Verlag in Georg Thieme Verlag Stuttgart · New York

Influence of an Antidiabetic Treatment with Sulfonylurea Drugs on Long-Term Survival after Acute Myocardial Infarction in Patients with Type 2 Diabetes

The LAngendreer Myocardial Infarction and Blood Glucose in Diabetic Patients Assessment (LAMBDA)J. J. Meier 1 , 2 , S. Deifuß 1 , A. Klamann 1 , W. Schmiegel 1 , M. A. Nauck 1 , 2 , 3
  • 1Department of Medicine, Knappschafts-Krankenhaus, Ruhr-University, Bochum, Germany
  • 2Department of Medicine I, St. Josef-Hospital, Ruhr-University, Bochum, Germany
  • 3Diabeteszentrum Bad Lauterberg im Harz, Germany
Weitere Informationen

Publikationsverlauf

Received: August 13, 2002 First decision: October 14, 2002

Accepted: January 10, 2003

Publikationsdatum:
01. Oktober 2003 (online)

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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

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Prof. Dr. med. Michael Nauck

Diabetes-Zentrum
Bad Lauterberg

Kirchberg 21

37431 Bad Lauterberg

Germany

Telefon: + 49 5524 81218

Fax: + 49 55 24 8 13 98

eMail: m.nauck@diabeteszentrum.de