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PubMed · 11575709

A clinical focus on statins.

J Auer·B Eber
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Abstract

Clinical trials have demonstrated that inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (statins) significantly reduce cardiovascular-related morbidity and mortality in patients with and without coronary artery disease. Furthermore, statins are currently the most potent cholesterol-lowering drugs available. Subanalyses of the LIPID study have shown that patients suffering from unstable angina pectoris had at least the same benefit from statin therapy as did patients after myocardial infarction. Studies, recently published (AVERT or MIRACL) provide more information on the topic of therapy with statins in the early phase of acute coronary syndromes.

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Angina PectorisAngioplasty, Balloon, CoronaryAnticholesteremic AgentsAtorvastatinCholesterolCholesterol, LDLClinical Trials as TopicCoronary DiseaseCost-Benefit AnalysisDown-RegulationFatty Acids, MonounsaturatedFluvastatinHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIndolesLovastatinMulticenter Studies as TopicMyocardial InfarctionPractice Guidelines as TopicPravastatinPyrrolesQuality of LifeRandomized Controlled Trials as TopicSimvastatinComparative StudyJournal ArticleReview

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J Auer, B Eber. 2001. A clinical focus on statins.. https://pubmed.ncbi.nlm.nih.gov/11575709/

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PubMed2007

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

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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