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Preadmission treatment with sulfonylureas and infarct size after ST-elevation myocardial infarction
International Journal of Cardiology 202 (2016) 519
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Correspondence
Preadmission treatment with sulfonylureas and infarct size after ST-elevation myocardial infarction Mehmet Eyuboglu Department of Cardiology, Special Izmir Avrupa Medicine Center, Karabaglar, Izmir 35170, Turkey
a r t i c l e
i n f o
Article history: Received 1 September 2015 Accepted 24 September 2015 Available online 26 September 2015 Keywords: Sulfonylureas ST-elevation myocardial infarction Infarct size Troponin I
Secondly, Abdelmoneim et al. mentioned the ischemic time in the text. However, there are no data about door-to balloon and door-toneedle time. Door-to balloon and door-to-needle time may be associated with prognosis independent of total ischemic time [4,5]. In this sense door-to balloon and door-to-needle time may affect the troponin I levels independently. In conclusion, preadmission use of sulfonylureas may be associated with larger infarct size in type 2 diabetes patients with STEMI. However, to define the exact predictive value of sulfonylureas for infarct size, all well known factors that are associated with elevated troponin levels should be taken into consideration. Conflict of interest
Dear Editor, I read the article with great interest by Abdelmoneim et al. [1], recently published online in your journal. In their study, the authors reported that preadmission treatment with sulfonylureas was associated with larger infarct size detected by troponin I compared to no sulfonylureas in type 2 diabetes patients presenting with ST-elevation myocardial infarction (STEMI). The authors identified the adverse effect of sulfonylureas usage in STEMI patients with diabetes. However, because of some flaws in the design of the study, I would like to make some criticism on the results of the present article. First, in the present study of Abdelmoneim et al., the authors did not report the left ventricular ejection fraction of study population and each group. Global left ventricular function is one of the most important prognostic factors in STEMI patients. Low left ventricle ejection fraction is a strong predictor for adverse events after myocardial infarction [2,3]. Also, low ejection fraction and heart failure may cause troponin I elevation independently. Hence, the authors should report the left ventricular ejection fraction of both groups. Significantly lower ejection fraction and heart failure in patients treated with sulfonylureas may be a reason of higher troponin I levels and adverse outcomes independently.
E-mail address: [email protected].
http://dx.doi.org/10.1016/j.ijcard.2015.09.092 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
I have no commercial, financial, and other relationships in any way related to the subject of this article all that might create any potential conflict of interest. Funding and support: Nothing to declare. References [1] S. Abdelmoneim Ahmed, Welsh Robert, T. Eurich Dean, H. Simpson Scot, Sulfonylurea use is associated with larger infarct size in patients with diabetes and ST-elevation myocardial infarction, Int. J. Cardiol. (2015)http://dx.doi.org/10.1016/j.ijcard.2015. 08.213. [2] A.W. Chan, S.N. Bakar, R.I. Brown, et al., In-hospital outcomes of a regional STsegment elevation myocardial infarction acute transfer and repatriation program, Can. J. Cardiol. 27 (664) (2011) e1–e8. [3] N. Dagres, G. Hindricks, Risk stratification after myocardial infarction: is left ventricular ejection fraction enough to prevent sudden cardiac death? Eur. Heart J. 34 (2013) 1964–1971. [4] R.L. McNamara, Y. Wang, J. Herrin, et al., Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction, J. Am. Coll. Cardiol. 47 (2006) 2180–2186. [5] P.G. Steg, S.K. James, D. Atar, et al., Task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation, Eur. Heart J. 33 (2012) 2569–2619.
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Correspondence
Preadmission treatment with sulfonylureas and infarct size after ST-elevation myocardial infarction Mehmet Eyuboglu Department of Cardiology, Special Izmir Avrupa Medicine Center, Karabaglar, Izmir 35170, Turkey
a r t i c l e
i n f o
Article history: Received 1 September 2015 Accepted 24 September 2015 Available online 26 September 2015 Keywords: Sulfonylureas ST-elevation myocardial infarction Infarct size Troponin I
Secondly, Abdelmoneim et al. mentioned the ischemic time in the text. However, there are no data about door-to balloon and door-toneedle time. Door-to balloon and door-to-needle time may be associated with prognosis independent of total ischemic time [4,5]. In this sense door-to balloon and door-to-needle time may affect the troponin I levels independently. In conclusion, preadmission use of sulfonylureas may be associated with larger infarct size in type 2 diabetes patients with STEMI. However, to define the exact predictive value of sulfonylureas for infarct size, all well known factors that are associated with elevated troponin levels should be taken into consideration. Conflict of interest
Dear Editor, I read the article with great interest by Abdelmoneim et al. [1], recently published online in your journal. In their study, the authors reported that preadmission treatment with sulfonylureas was associated with larger infarct size detected by troponin I compared to no sulfonylureas in type 2 diabetes patients presenting with ST-elevation myocardial infarction (STEMI). The authors identified the adverse effect of sulfonylureas usage in STEMI patients with diabetes. However, because of some flaws in the design of the study, I would like to make some criticism on the results of the present article. First, in the present study of Abdelmoneim et al., the authors did not report the left ventricular ejection fraction of study population and each group. Global left ventricular function is one of the most important prognostic factors in STEMI patients. Low left ventricle ejection fraction is a strong predictor for adverse events after myocardial infarction [2,3]. Also, low ejection fraction and heart failure may cause troponin I elevation independently. Hence, the authors should report the left ventricular ejection fraction of both groups. Significantly lower ejection fraction and heart failure in patients treated with sulfonylureas may be a reason of higher troponin I levels and adverse outcomes independently.
E-mail address: [email protected].
http://dx.doi.org/10.1016/j.ijcard.2015.09.092 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
I have no commercial, financial, and other relationships in any way related to the subject of this article all that might create any potential conflict of interest. Funding and support: Nothing to declare. References [1] S. Abdelmoneim Ahmed, Welsh Robert, T. Eurich Dean, H. Simpson Scot, Sulfonylurea use is associated with larger infarct size in patients with diabetes and ST-elevation myocardial infarction, Int. J. Cardiol. (2015)http://dx.doi.org/10.1016/j.ijcard.2015. 08.213. [2] A.W. Chan, S.N. Bakar, R.I. Brown, et al., In-hospital outcomes of a regional STsegment elevation myocardial infarction acute transfer and repatriation program, Can. J. Cardiol. 27 (664) (2011) e1–e8. [3] N. Dagres, G. Hindricks, Risk stratification after myocardial infarction: is left ventricular ejection fraction enough to prevent sudden cardiac death? Eur. Heart J. 34 (2013) 1964–1971. [4] R.L. McNamara, Y. Wang, J. Herrin, et al., Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction, J. Am. Coll. Cardiol. 47 (2006) 2180–2186. [5] P.G. Steg, S.K. James, D. Atar, et al., Task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation, Eur. Heart J. 33 (2012) 2569–2619.