TY - JOUR

T1 - Comparable long-term mortality risk associated with individual sulfonylureas in diabetes patients with heart failure

AU - Andersson, Charlotte

AU - Gislason, Gunnar H

AU - Jørgensen, Casper H

AU - Hansen, Peter R

AU - Vaag, Allan

AU - Sørensen, Rikke

AU - Mérie, Charlotte

AU - Olesen, Jonas B

AU - Weeke, Peter

AU - Schmiegelow, Michelle

AU - Norgaard, Mette L

AU - Køber, Lars

AU - Torp-Pedersen, Christian

N1 - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

PY - 2011

Y1 - 2011

N2 - The aim was to investigate the outcomes of individual sulfonylureas in patients with heart failure (HF). Methods All patients hospitalized with HF for the first time in 1997–2006, alive 30 days after discharge, and who received anti-diabetic monotherapy with glimepiride (n = 1097), glibenclamide (glyburide) (n = 1031), glipizide (n = 557), gliclazide (n = 251), or tolbutamide (n = 541) were identified from nationwide registers. Risk of all-cause mortality was assessed by multivariable Cox regression models. Results Over the median observational time of 744 (Inter Quartile Range 268–1451) days, 2242 patients (64%) died. The analysis demonstrated similar hazard ratio (HR) for mortality for treatment with glimepiride (1.10 [95% confidence interval 0.92–1.33]), glibenclamide (1.12 [0.93–1.34]), glipizide (1.14 [0.93–1.38]), tolbutamide (1.04 [0.85–1.26]), and gliclazide (reference). Grouped according to pancreatic specificity, i.e., with tolbutamide, glipizide, and gliclazide as specific, and glibenclamide, and glimepiride as non-specific agents, no differential prognosis was found between the two groups (HR 1.04 [0.96–1.14], for non-specific, compared to pancreas specific agents). The prognosis was not dependent on prior acute myocardial infarction or ischemic heart disease (p for interactions >0.3). Conclusions In current clinical practice, it is unlikely that there are considerable differences in risk of mortality associated with individual sulfonylureas in patients with heart failure.

AB - The aim was to investigate the outcomes of individual sulfonylureas in patients with heart failure (HF). Methods All patients hospitalized with HF for the first time in 1997–2006, alive 30 days after discharge, and who received anti-diabetic monotherapy with glimepiride (n = 1097), glibenclamide (glyburide) (n = 1031), glipizide (n = 557), gliclazide (n = 251), or tolbutamide (n = 541) were identified from nationwide registers. Risk of all-cause mortality was assessed by multivariable Cox regression models. Results Over the median observational time of 744 (Inter Quartile Range 268–1451) days, 2242 patients (64%) died. The analysis demonstrated similar hazard ratio (HR) for mortality for treatment with glimepiride (1.10 [95% confidence interval 0.92–1.33]), glibenclamide (1.12 [0.93–1.34]), glipizide (1.14 [0.93–1.38]), tolbutamide (1.04 [0.85–1.26]), and gliclazide (reference). Grouped according to pancreatic specificity, i.e., with tolbutamide, glipizide, and gliclazide as specific, and glibenclamide, and glimepiride as non-specific agents, no differential prognosis was found between the two groups (HR 1.04 [0.96–1.14], for non-specific, compared to pancreas specific agents). The prognosis was not dependent on prior acute myocardial infarction or ischemic heart disease (p for interactions >0.3). Conclusions In current clinical practice, it is unlikely that there are considerable differences in risk of mortality associated with individual sulfonylureas in patients with heart failure.

U2 - 10.1016/j.diabres.2011.07.011

DO - 10.1016/j.diabres.2011.07.011

M3 - Journal article

C2 - 21831467

VL - 94

SP - 119

EP - 125

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

SN - 0168-8227

IS - 1

ER -