Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris

Abstract

Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

Escore eletrocardiográfico: aplicação em ergometria para avaliação do precondicionamento isquêmico

“…In the present study, repaglinide brought about negative modifications not only in the warm-up phenomenon, but also in the exercise tolerance indexes and the post-exercise electrocardiographic response 16 . By blocking K-ATP channels of beta-pancreatic cells, sulfonylureas and glinides can also act in myocardial K-ATP channels suppressing IPC 3,[13][14][15][16][17][18] .…”

“…Indexes based on angina are limited because it occurs in less than 50.0% of the cases; also, it is a symptom that is subject to very different interpretations due to its subjective nature 16 . Improvement in T-1.0 mm is classically adopted for the characterization of IPC.…”

“…By blocking K-ATP channels of beta-pancreatic cells, sulfonylureas and glinides can also act in myocardial K-ATP channels suppressing IPC 3,[13][14][15][16][17][18] . For suppressing this phenomenon of myocardial protection, the repaglinide action is assumed as deleterious, with a potential harmful effect on the myocardium in face of ischemic events.…”

“…Some studies adopting the SET model demonstrated that sulfonylureas [13][14][15] and glinides 16 block IPC in diabetic patients with coronary insufficiency. This IPC blockade was considered to be the explanation for the increased cardiovascular mortality seen in diabetic patients being treated with sulfonylureas in the UGDP study…”

Expressão do precondicionamento isquêmico em pacientes com diabetes mellitus tipo 2 e doença arterial coronariana

“…Lee e colaboradores (17) estudaram (61,62) . Adicionalmente, alguns autores sugerem que esta interferência de medicamentos sobre o PI pode ser uma das explicações para o pior prognóstico de pacientes com diabetes internados em decorrência de infarto agudo do miocárdio (63) .…”