Objective To assess the adverse effects of glibenclamide on the myocardium, for investigating more effective and rational therapy.
Methods 115 consecutive patients were enrolled into the study. All patients had clinical histories of acute myocardial infarction and losed the chance of thrombolysis and emergency PCI; Each patient was assigned to either insulin or glibenclamide group according to which treatment he accepted outside hospital regularly. The patients who took glibenclamide for group A, insulin for group B and diet for group C. Collected the basical clinical informations of all patients. One month after PCI all patients took SPECT to evaluate the condition of myocardial perfusion, and ERNA for LVEF.
Results The ratio of the patients with <TIMI III grade in the three groups were statistically significant difference. The incidence of arrhythmia of the three groups were significantly difference. In the rest state, the ratio of abnormal myocardial perfusion segments in the three groups were statistically significant difference. The ischaemic myocardial area score group A was significantly higher than group B and group C, group B and group C were no significant difference. ERNA showed that LVEF in the three groups were statistically significant difference. Group A was significantly lower than group B, there were no significant difference between group B and group C, group A, group C differences were statistically significant illustrated the LVEF of group A was significantly lower than group B and group C.
Conclusion Glibenclamide would increase myocardial ischaemic area in patients with acute myocardial infarction and type 2 diabetes mellitus. Glibenclamide increases the possibility of malignant arrhythmias in the patients with acute myocardial infarction and type 2 diabetes mellitus.