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

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 - 2011/10

Y1 - 2011/10

N2 - Aims: 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 - Aims: 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

SN - 0168-8227

VL - 94

SP - 119

EP - 125

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

IS - 1

ER -