| Clot-busters don't work well for
diabetics
NEW YORK (Reuters Health) - 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 Care, April 2004.
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