Abstract 19610: Role of Hypoglycemic Agents on Ischemic Preconditioning in Diabetic Patients with Stable Multivessel Coronary Artery Disease
Abstract only Background: Ischemic preconditioning (IPC) protects the heart from irreversible injury and some hypoglycemic drugs can abolish IPC, affecting infarct size and contractile function and contributing to a worse prognosis. We aimed to evaluate the effect of 2 hypoglycemic agents on myocard...
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Published in | Circulation (New York, N.Y.) Vol. 126; no. suppl_21 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
20.11.2012
|
Online Access | Get full text |
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Summary: | Abstract only
Background:
Ischemic preconditioning (IPC) protects the heart from irreversible injury and some hypoglycemic drugs can abolish IPC, affecting infarct size and contractile function and contributing to a worse prognosis. We aimed to evaluate the effect of 2 hypoglycemic agents on myocardial IPC in patients with type 2 diabetes and symptomatic coronary artery disease.
Methods:
We evaluated 81 patients, consecutively included, with type 2 diabetes, previous positive exercise test and multivessel coronary disease confirmed by coronary angiography. In phase I, without drug, all patients underwent 2 consecutive treadmill exercise tests (T1 and T2). After that, we started the phase II: 42 patients received repaglinide 6 mg per day (group R) and 38 pacients received Vildagliptin 100 mg per day ( group V), during one week and underwent 2 sequential tests (T3 and T4). The time interval between the exercise tests was 30 minutes.
Results:
In phase 1, IPC was demonstrated, in all patients, by improvement in the time to 1.0 mm of ST segment depression (T-1.0mm) in second of two sequential tests. All patients developed ischemia in T3; however, 83.3% of patients in group R experienced ischemia earlier in T4, indicating the cessation of IPC (
P
<0.0001). In group V, only 28% of patients demonstrated IPC cessation, with 72% still preserving the protective effect (
P
<0.0069).
Conclusions:
Repaglinide eliminated myocardial IPC, probably by its effect on the ATP-K channel. Vildagliptin did not affect this protective mechanism in a relevant way in patients with type 2 diabetes and coronary artery disease, suggesting a good alternative treatment in this population. |
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ISSN: | 0009-7322 1524-4539 |
DOI: | 10.1161/circ.126.suppl_21.A19610 |