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. 2018 Apr;20(4):1056-1060.
doi: 10.1111/dom.13168. Epub 2017 Dec 27.

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

Judith van Dalem  1   2 , Martijn C G J Brouwers  3 , Coen D A Stehouwer  4 , André Krings  5 , Olaf H Klungel  6 , Johanna H M Driessen  1   2   6   7 , Frank de Vries  1   2   6 , Andrea M Burden  1   2   6
Affiliations

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

Judith van Dalem et al. Diabetes Obes Metab. 2018 Apr.

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 = 121 869), aged ≥18 years, 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.

Keywords: acute myocardial infarction; all-cause mortality; sulphonylureas; type 2 diabetes mellitus.

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Conflict of interest statement

O. K. reports receiving funding from GSK, IMI PROTECT and IMI EU2P, in addition personal fees from educational lecture on methods to control for confounding for Roche. These sources are outside of the submitted work. Other authors declare no support from any organization for the submitted work, no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years, and no other relationships or activities that could appear to have influenced the submitted work.

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