Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study

C H Jørgensen; G H Gislason; D Bretler; R Sørensen; M L Norgaard; Morten Lock Hansen; T K Schramm; S Z Abildstrom; C Torp-Pedersen; P R Hansen; Casper Haslund Jørgensen; Rikke Sørensen; Steen Zabell Abildstrøm

doi:10.1016/j.ijcard.2010.07.027

Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study

C H Jørgensen, G H Gislason, D Bretler, R Sørensen, M L Norgaard, Morten Lock Hansen, T K Schramm, S Z Abildstrom, C Torp-Pedersen, P R Hansen, Casper Haslund Jørgensen, Rikke Sørensen, Steen Zabell Abildstrøm

18 Citations (Scopus)

Abstract

BACKGROUND: Sulfonylureas have been linked to an increased cardiovascular risk by inhibition of myocardial preconditioning. Whether individual sulfonylureas affect outcomes in diabetic patients after emergent percutaneous coronary intervention for myocardial infarction is unknown. METHODS: All Danish patients receiving glucose-lowering drugs admitted with myocardial infarction between 1997 and 2006 who underwent emergent percutaneous coronary intervention were identified from national registers. Multivariable Cox proportional hazards models were used to analyze the risk of cardiovascular mortality and morbidity associated with sulfonylureas. RESULTS: A total of 926 patients were included and 163 (17.6%) patients died during the first year of which 155 (16.7%) were cardiovascular deaths. The most common treatment was sulfonylureas which were received by 271 (29.3%) patients, and 129 (13.9%) received metformin. Cox proportional hazard regression analyses adjusted for age, sex, calendar year, comorbidity and concomitant pharmacotherapy showed an increased risk of cardiovascular mortality (hazard ratio [HR] 2.91, 95% confidence interval [CI] 1.26-6.72 ; p=0.012), cardiovascular mortality and nonfatal myocardial infarction (HR 2.69 , 95% CI 1.21-6.00; p=0.016), and all-cause mortality (HR 2.46, 95% CI 1.11-5.47; p=0.027), respectively, with glyburide compared to metformin. CONCLUSIONS: Glyburide is associated with increased cardiovascular mortality and morbidity in patients with diabetes mellitus undergoing emergent percutaneous coronary intervention after myocardial infarction. Early reperfusion therapy is the mainstay in modern treatment of myocardial infarction and the time may have come to discard glyburide in favour of sulfonylureas that do not appear to confer increased cardiovascular risk.

Original language	English
Journal	International Journal of Cardiology
Volume	152
Issue number	3
Pages (from-to)	327-331
ISSN	0167-5273
DOIs	https://doi.org/10.1016/j.ijcard.2010.07.027
Publication status	Published - 3 Nov 2011

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Jørgensen, C. H., Gislason, G. H., Bretler, D., Sørensen, R., Norgaard, M. L., Hansen, M. L., Schramm, T. K., Abildstrom, S. Z., Torp-Pedersen, C., Hansen, P. R., Jørgensen, C. H., Sørensen, R., & Abildstrøm, S. Z. (2011). Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study. International Journal of Cardiology, 152(3), 327-331. https://doi.org/10.1016/j.ijcard.2010.07.027

Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study. / Jørgensen, C H; Gislason, G H; Bretler, D et al.

In: International Journal of Cardiology, Vol. 152, No. 3, 03.11.2011, p. 327-331.

Research output: Contribution to journal › Journal article › Research › peer-review

Jørgensen, CH, Gislason, GH, Bretler, D, Sørensen, R, Norgaard, ML, Hansen, ML, Schramm, TK, Abildstrom, SZ, Torp-Pedersen, C , Hansen, PR, Jørgensen, CH, Sørensen, R & Abildstrøm, SZ 2011, 'Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study', International Journal of Cardiology, vol. 152, no. 3, pp. 327-331. https://doi.org/10.1016/j.ijcard.2010.07.027

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title = "Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study",

abstract = "BACKGROUND: Sulfonylureas have been linked to an increased cardiovascular risk by inhibition of myocardial preconditioning. Whether individual sulfonylureas affect outcomes in diabetic patients after emergent percutaneous coronary intervention for myocardial infarction is unknown. METHODS: All Danish patients receiving glucose-lowering drugs admitted with myocardial infarction between 1997 and 2006 who underwent emergent percutaneous coronary intervention were identified from national registers. Multivariable Cox proportional hazards models were used to analyze the risk of cardiovascular mortality and morbidity associated with sulfonylureas. RESULTS: A total of 926 patients were included and 163 (17.6%) patients died during the first year of which 155 (16.7%) were cardiovascular deaths. The most common treatment was sulfonylureas which were received by 271 (29.3%) patients, and 129 (13.9%) received metformin. Cox proportional hazard regression analyses adjusted for age, sex, calendar year, comorbidity and concomitant pharmacotherapy showed an increased risk of cardiovascular mortality (hazard ratio [HR] 2.91, 95% confidence interval [CI] 1.26-6.72 ; p=0.012), cardiovascular mortality and nonfatal myocardial infarction (HR 2.69 , 95% CI 1.21-6.00; p=0.016), and all-cause mortality (HR 2.46, 95% CI 1.11-5.47; p=0.027), respectively, with glyburide compared to metformin. CONCLUSIONS: Glyburide is associated with increased cardiovascular mortality and morbidity in patients with diabetes mellitus undergoing emergent percutaneous coronary intervention after myocardial infarction. Early reperfusion therapy is the mainstay in modern treatment of myocardial infarction and the time may have come to discard glyburide in favour of sulfonylureas that do not appear to confer increased cardiovascular risk.",

author = "J{\o}rgensen, {C H} and Gislason, {G H} and D Bretler and R S{\o}rensen and Norgaard, {M L} and Hansen, {Morten Lock} and Schramm, {T K} and Abildstrom, {S Z} and C Torp-Pedersen and Hansen, {P R} and J{\o}rgensen, {Casper Haslund} and Rikke S{\o}rensen and Abildstr{\o}m, {Steen Zabell}",

year = "2011",

month = nov,

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doi = "10.1016/j.ijcard.2010.07.027",

language = "English",

volume = "152",

pages = "327--331",

journal = "International Journal of Cardiology",

issn = "0167-5273",

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TY - JOUR

T1 - Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study

AU - Jørgensen, C H

AU - Gislason, G H

AU - Bretler, D

AU - Sørensen, R

AU - Norgaard, M L

AU - Hansen, Morten Lock

AU - Schramm, T K

AU - Abildstrom, S Z

AU - Torp-Pedersen, C

AU - Hansen, P R

AU - Jørgensen, Casper Haslund

AU - Sørensen, Rikke

AU - Abildstrøm, Steen Zabell

PY - 2011/11/3

Y1 - 2011/11/3

N2 - BACKGROUND: Sulfonylureas have been linked to an increased cardiovascular risk by inhibition of myocardial preconditioning. Whether individual sulfonylureas affect outcomes in diabetic patients after emergent percutaneous coronary intervention for myocardial infarction is unknown. METHODS: All Danish patients receiving glucose-lowering drugs admitted with myocardial infarction between 1997 and 2006 who underwent emergent percutaneous coronary intervention were identified from national registers. Multivariable Cox proportional hazards models were used to analyze the risk of cardiovascular mortality and morbidity associated with sulfonylureas. RESULTS: A total of 926 patients were included and 163 (17.6%) patients died during the first year of which 155 (16.7%) were cardiovascular deaths. The most common treatment was sulfonylureas which were received by 271 (29.3%) patients, and 129 (13.9%) received metformin. Cox proportional hazard regression analyses adjusted for age, sex, calendar year, comorbidity and concomitant pharmacotherapy showed an increased risk of cardiovascular mortality (hazard ratio [HR] 2.91, 95% confidence interval [CI] 1.26-6.72 ; p=0.012), cardiovascular mortality and nonfatal myocardial infarction (HR 2.69 , 95% CI 1.21-6.00; p=0.016), and all-cause mortality (HR 2.46, 95% CI 1.11-5.47; p=0.027), respectively, with glyburide compared to metformin. CONCLUSIONS: Glyburide is associated with increased cardiovascular mortality and morbidity in patients with diabetes mellitus undergoing emergent percutaneous coronary intervention after myocardial infarction. Early reperfusion therapy is the mainstay in modern treatment of myocardial infarction and the time may have come to discard glyburide in favour of sulfonylureas that do not appear to confer increased cardiovascular risk.

AB - BACKGROUND: Sulfonylureas have been linked to an increased cardiovascular risk by inhibition of myocardial preconditioning. Whether individual sulfonylureas affect outcomes in diabetic patients after emergent percutaneous coronary intervention for myocardial infarction is unknown. METHODS: All Danish patients receiving glucose-lowering drugs admitted with myocardial infarction between 1997 and 2006 who underwent emergent percutaneous coronary intervention were identified from national registers. Multivariable Cox proportional hazards models were used to analyze the risk of cardiovascular mortality and morbidity associated with sulfonylureas. RESULTS: A total of 926 patients were included and 163 (17.6%) patients died during the first year of which 155 (16.7%) were cardiovascular deaths. The most common treatment was sulfonylureas which were received by 271 (29.3%) patients, and 129 (13.9%) received metformin. Cox proportional hazard regression analyses adjusted for age, sex, calendar year, comorbidity and concomitant pharmacotherapy showed an increased risk of cardiovascular mortality (hazard ratio [HR] 2.91, 95% confidence interval [CI] 1.26-6.72 ; p=0.012), cardiovascular mortality and nonfatal myocardial infarction (HR 2.69 , 95% CI 1.21-6.00; p=0.016), and all-cause mortality (HR 2.46, 95% CI 1.11-5.47; p=0.027), respectively, with glyburide compared to metformin. CONCLUSIONS: Glyburide is associated with increased cardiovascular mortality and morbidity in patients with diabetes mellitus undergoing emergent percutaneous coronary intervention after myocardial infarction. Early reperfusion therapy is the mainstay in modern treatment of myocardial infarction and the time may have come to discard glyburide in favour of sulfonylureas that do not appear to confer increased cardiovascular risk.

U2 - 10.1016/j.ijcard.2010.07.027

DO - 10.1016/j.ijcard.2010.07.027

M3 - Journal article

C2 - 20797803

SN - 0167-5273

VL - 152

SP - 327

EP - 331

JO - International Journal of Cardiology

JF - International Journal of Cardiology

IS - 3

ER -

Glyburide increases risk in patients with diabetes mellitus after emergent percutaneous intervention for myocardial infarction - A nationwide study

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