Effect of pharmacological treatment on cardiac biomarkers in patients with acute coronary syndrome of non–ST segment elevation with Type-2 diabetes

Abstract

The acute coronary syndrome is a consequence of coronary artery disease. Creatine Kinase MB is a cardiac biochemical marker used in the diagnosis and risk stratification of patients. The diabetes is a pathology associated to acute coronary syndrome non–ST segment elevation that change the cardiac conditions, in this sense, our objective was to evaluate the modifications of cardiac biomarkers values in diabetic patients. Materials and methods: A retrospective study included 155 patients of both sexes, ages ranging from 31 to 92 years old, admitted to the coronary unit of the “Reina Fabiola†Clinic, Córdoba, Argentina was performed in the period 2014-2015. Body mass index, time consultation pain, plasmatic Creatine Kinase isoenzyme MB activity and Troponin I levels were measured. The patients were stratified into two groups: without cardiovascular risk pathologies (Control group), n = 7; and with only type II diabetes, n = 64 treated with therapeutic doses of metformin (n= 37), and glibenclamide plus glizipide (n= 27). Results: cTnI levels were lower in both pharmacological treatments at 12 hrs when the values in control reach the highest. Similarly, CK-MB activity was lower at 8 hrs in both treatments; however at 12 hrs these values were lower only with metformin but not in glibenclamide plus glizipide treatment. These results could be showing an interaction between diabetes and pharmacological treatment upon the biomarkers values. Conclusion: The use of hypoglycemic drugs and the glycometabolic state are conditions that could modify CK-MB and cTnI release/clearance balance at 8 and 12 hrs after admission to the coronary unit.