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Clot-busters Don't Work Well for Diabetics
posted 04/29/04
Better option to treat with balloon angioplasty and/or
a stent to open coronary arteries.
Heart attacks are routinely treated with clot-buster drugs to open up blocked
coronary arteries, but Greek researchers report that this approach is not very
effective for people with type 2 diabetes.
Dr. Michael N. Zairis and colleagues at Tzanio Hospital in Piraeus note in the
medical journal Diabetes Care that there is evidence that diabetics treated with
clot-dissolving drugs after a heart attack fare more poorly than those without
diabetes.
To help determine why this might be, the researchers followed 726 survivors of a
heart attack, 214 of whom had type 2 diabetes, for up to 3.5 years.
All had had been given clot-dissolving drugs within six hours of first
experiencing chest pain.
Fewer diabetics than nondiabetics showed full normalization of their
echocardiogram (indicating clot clearance) after treatment, and both diabetic
and nondiabetic patients who failed to show recovery had a significantly
elevated risk of dying.
Moreover, those patients with diabetes whose electrocardiogram did show more
complete recovery took significantly longer to do so than did the nondiabetic
patients.
In addition, diabetics who took 60 minutes or more after the start of
clot-buster treatment to achieve a normal electrocardiogram reading were at
significantly increased risk of death. This was not true for nondiabetic
patients.
The investigators conclude that "more appropriate therapeutic approaches" may
improve the outlook for diabetic patients when they suffer a heart attack. An
alternative to clot-dissolving drugs is to treat patients immediately with
balloon angioplasty and/or a stent to open coronary arteries.
Source: Diabetes In Control.com: Diabetes Care, April 2004.
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