【摘 要】
：
Cardiovascular disease is the major cause of death in both type lor type 2 diabetes.Current treatments reduce morbidity and mortality, but patients with diabetes continue to have 2 to 4 times the risk
【机 构】
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Royal North Shore Hospital & University of Sydney Australia
【出 处】
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MIT`s 1st Annual World Congress of Diabetes-2012(2012第一届糖尿病大
论文部分内容阅读
Cardiovascular disease is the major cause of death in both type lor type 2 diabetes.Current treatments reduce morbidity and mortality, but patients with diabetes continue to have 2 to 4 times the risk of myocardial infarction (MI) and heart failure and do not show the same benefit following reperfusion strategies.Diabetes remains an independent predictor of adverse events after percutaneous coronary intervention (PCI).Using an ex-vivo experimental myocardial infarction model, we have found hyperglycaemia increases cardiomyocyte apoptosis during experimental myocardial infarction that was consistent with increased infarct zone area.The role of aldosterone as a risk factor in the cardiovascular complications of diabetes has recently gained interest, with elevated plasma aldosterone levels doubling the risk of mortality during PCI, while MR blockade with eplerenone reduces proteinuria in diabetic patients.Several large clinical trials show that the addition of MR antagonists to standard therapy for heart failure substantially (30%) reduced mortality and decreased hospitalization;in these trials 32% of patients were diabetic.Using an animal model of type 2 diabetes, the Zucker rat, we found larger infarct area following ex-vivo myocardial ischemia-reperfusion.Acute perfusion of the mineralocorticoid receptor, spironolactone (1 M) 15 min before ischaemia reduced infarct size to levels similar to ischemia-reperfusion alone;mechanisms currently being investigated.
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