Premium
Sulphonylureas monotherapy and risk of hospitalization for heart failure in patients with type 2 diabetes mellitus: A population‐based cohort study in China
Author(s) -
Xu Yang,
Wang Tiansheng,
Yang Zhirong,
Lin Hongbo,
Shen Peng,
Zhan Siyan
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.5024
Subject(s) - acarbose , medicine , hazard ratio , type 2 diabetes mellitus , diabetes mellitus , heart failure , incidence (geometry) , proportional hazards model , cohort , retrospective cohort study , gastroenterology , confidence interval , endocrinology , physics , optics
Purpose The risk of heart failure associated with sulphonylureas is unclear. We evaluated the association between sulphonylureas and hospitalization of heart failure (HHF) in patients with type 2 diabetes mellitus (T2DM) in China. Methods A retrospective cohort study was implemented using the Yinzhou Regional Health Care Database (YRHCD). We identified 15 752 adult patients with T2DM who were newly exposed to sulphonylurea monotherapy (N = 12 487) or acarbose monotherapy (N = 3265) from January 2010 to September 2016. Cox proportional hazards models weighted by inverse probability of treatment weights were used to compare the risk of HHF between initiators of sulphonylurea and acarbose. Results During a median follow‐up of 0.55 (0.49, 1.11) and 0.49 (0.35, 0.70) years for sulphonylureas and acarbose initiators separately, 320 patients developed HHF, with 279 events in sulphonylureas group, and 41 events in acarbose group. The incidence rates of HHF among sulphonylureas initiators and acarbose initiators were 22.2 (95% CI 19.6‐24.9) and 18.3 (95% CI 13.2‐24.9) per 1000 person‐years, respectively. The adjusted hazard ratio (aHR) of HHF for sulphonylureas vs acarbose was 1.61 (95% CI 1.14‐2.27). When stratified by history of heart failure, aHR was 1.55 (95% CI 0.79‐3.06) in patients with a history of heart failure, and 1.64 (95% CI 1.10‐2.45) in patients with no history of heart failure. Conclusions Our study suggested that use of sulphonylureas monotherapy compared with acarbose monotherapy for initial treatment of T2DM for approximately 0.5 years are significantly associated with a higher risk of HHF.