Risk of a first-ever acute myocardial infarction and all-cause mortality with sulphonylurea treatment: A population-based cohort study

Judith van Dalem, Martijn C. G. J. Brouwers, Coen D. A. Stehouwer, Andre Krings, Olaf H. Klungel, Johanna H. M. Driessen, Frank de Vries*, Andrea M. Burden

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Web of Science)

Abstract

We investigated the association between the current use of individual sulphonylureas and the risk of a first-ever acute myocardial infarction (AMI) and all-cause mortality, in a population-based cohort study, using primary care data from the Clinical Practice Research Datalink database (2004-2012). New users (N=121869), aged 18years, with at least one prescription for a non-insulin antidiabetic agent were included. The first prescription defined start of follow-up. Time-dependent Cox proportional hazard models were used to estimate the risk of a first-ever AMI and all-cause mortality associated with the use of individual sulphonylureas, and other non-insulin glucose-lowering drugs. No differences in risk of a first-ever AMI (adjusted hazard ratio [HR] 1.02, 95% confidence interval [CI] 0.70-1.50) or all-cause mortality (adjusted HR 0.97, 95% CI 0.80-1.17) were observed when comparing gliclazide use with non-gliclazide sulphonylurea use. Similar results were found for each individual sulphonylurea. As evidence is accumulating that gliclazide is no safer than other sulphonylureas, current guidelines suggesting superiority should be carefully evaluated.

Original languageEnglish
Pages (from-to)1056-1060
Number of pages5
JournalDiabetes Obesity & Metabolism
Volume20
Issue number4
DOIs
Publication statusPublished - Apr 2018

Keywords

  • acute myocardial infarction
  • all-cause mortality
  • sulphonylureas
  • type 2 diabetes mellitus
  • CARDIOVASCULAR SAFETY
  • SEVERE HYPOGLYCEMIA
  • METAANALYSIS
  • EVENTS
  • ASSOCIATION
  • MONOTHERAPY
  • METFORMIN
  • OUTCOMES
  • USERS
  • DEATH
  • Humans
  • Middle Aged
  • Male
  • Cause of Death
  • Young Adult
  • Sulfonylurea Compounds/adverse effects
  • Aged, 80 and over
  • Adult
  • Female
  • Risk Factors
  • Myocardial Infarction/chemically induced
  • United Kingdom/epidemiology
  • Diabetes Mellitus, Type 2/drug therapy
  • Adolescent
  • Survival Analysis
  • Aged
  • Hypoglycemic Agents/adverse effects
  • Cohort Studies

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