Comparative Impact of Hypoglycemic Agents on Severity and Extent of Myocardial Ischemia in Patients With Type 2 Diabetes Mellitus Undergoing Myocardial Perfusion Scintigraphy
| Autor: | Francesco Versaci, Annamaria Pinto, Mariangela Peruzzi, Giuseppe Biondi-Zoccai, Giorgio Sesti, Enrica Procaccini, Giandomenico Neri, Luigi Uccioli, Maurizio Vetere, Francesco Nudi |
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| Rok vydání: | 2016 |
| Předmět: |
Databases
Factual medicine.medical_treatment Settore MED/11 - Malattie dell'Apparato Cardiovascolare 030204 cardiovascular system & hematology dombination 0302 clinical medicine middle aged coronary artery disease diabetes mellitus hypoglycemic agents ischemia myocardial perfusion scintigraphy aged chi-square distribution coronary angiography databases factual diabetes mellitus type 2 drug therapy dombination female humans insulin male metformin multivariate analysis myocardial ischemia myocardial perfusion imaging odds ratio predictive value of tests retrospective studies risk factors severity of illness index sulfonylurea compounds treatment outcome tomography emission-computed single-photon pharmacology cardiology and cardiovascular medicine medicine.diagnostic_test drug therapy Metformin type 2 factual Cardiology Drug Therapy Combination Cardiology and Cardiovascular Medicine Perfusion medicine.drug medicine.medical_specialty databases 030209 endocrinology & metabolism 03 medical and health sciences Myocardial perfusion imaging Pharmacotherapy Internal medicine Diabetes mellitus Severity of illness medicine Tomography Emission-Computed Single-Photon Pharmacology business.industry Insulin Type 2 Diabetes Mellitus medicine.disease Diabetes Mellitus Type 2 business |
| Zdroj: | Journal of Cardiovascular Pharmacology. 68:162-170 |
| ISSN: | 0160-2446 |
| Popis: | Hypoglycemic agents differ in mechanism, efficacy, and profile. However, there is uncertainty on their impact on myocardial perfusion. We thus aimed to investigate whether individuals with type 2 diabetes mellitus treated with different drug classes exhibit different perfusion patterns at myocardial perfusion scintigraphy (MPS).We queried our administrative database for patients with diabetes mellitus without prior or recent myocardial infarction. The primary objective was to compare the severity and extent of ischemia at MPS, distinguishing patients according to management strategy. A total of 7592 patients were included [2336 (31%) on diet, 3611 (48%) on metformin, 749 (10%) on sulfonylureas, 449 (6%) on metformin plus sulfonylureas, 447 (6%) on metformin plus insulin]. Unadjusted analyses and analyses adjusting for baseline features suggested that sulfonylureas alone or in combination were associated with more severe ischemia than nonsulfonylurea regimens (P0.05), whereas combination regimens including metformin were associated with more extensive myocardial ischemia than the other regimens (P0.05 for both). However, no significant difference disfavoring either metformin or sulfonylurea regimens persisted after multivariable adjustment for baseline, stress, and angiographic characteristics (all P0.05).Several significant differences in baseline, stress, and scintigraphic features appear evident in patients with diabetes mellitus receiving different hypoglycemic agents or regimens. |
| Databáze: | OpenAIRE |
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