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Risk of a first‐ever acute myocardial infarction and all‐cause mortality with sulphonylurea treatment: A population‐based cohort study
Author(s) -
van Dalem Judith,
Brouwers Martijn C. G. J.,
Stehouwer Coen D. A.,
Krings André,
Klungel Olaf H.,
Driessen Johanna H. M.,
de Vries Frank,
Burden Andrea M.
Publication year - 2018
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13168
Subject(s) - medicine , gliclazide , hazard ratio , myocardial infarction , confidence interval , proportional hazards model , cohort , medical prescription , population , cohort study , diabetes mellitus , insulin , cardiology , pharmacology , endocrinology , environmental health
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.