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  • Title: Comparable long-term mortality risk associated with individual sulfonylureas in diabetes patients with heart failure.
    Author: Andersson C, Gislason GH, Jørgensen CH, Hansen PR, Vaag A, Sørensen R, Mérie C, Olesen JB, Weeke P, Schmiegelow M, Norgaard ML, Køber L, Torp-Pedersen C.
    Journal: Diabetes Res Clin Pract; 2011 Oct; 94(1):119-25. PubMed ID: 21831467.
    Abstract:
    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.
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