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Comparable long-term mortality risk associated with individual sulfonylureas in diabetes patients with heart failure

Charlotte Andersson1, Gunnar H Gislason, Casper H Jørgensen

  • 1Department of Cardiology, Copenhagen University Hospital, Gentofte, Hellerup, Denmark. ca@heart.dk

Diabetes Research and Clinical Practice
|August 12, 2011
PubMed

Insights

Individual sulfonylureas show similar mortality risks in heart failure patients. This study found no significant differences in all-cause mortality among glimepiride, glibenclamide, glipizide, gliclazide, and tolbutamide treatments for heart failure patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Heart failure (HF) management requires careful consideration of comorbidities and medication safety.
  • Sulfonylureas are commonly prescribed anti-diabetic agents, but their comparative safety in HF patients is not well-established.

Purpose of the Study:

  • To investigate the comparative outcomes, specifically all-cause mortality, associated with individual sulfonylurea medications in patients hospitalized with heart failure.

Main Methods:

  • A nationwide register-based cohort study identified patients hospitalized for heart failure between 1997-2006.
  • Patients receiving monotherapy with specific sulfonylureas (glimepiride, glibenclamide, glipizide, gliclazide, tolbutamide) were analyzed.
  • Multivariable Cox regression models assessed the risk of all-cause mortality.

Main Results:

  • Over a median follow-up of 744 days, 64% of patients died. No significant differences in mortality hazard ratios were observed among the individual sulfonylureas.
  • Pancreatic specificity of sulfonylureas did not correlate with differential mortality risk.
  • Prognosis was not influenced by a history of acute myocardial infarction or ischemic heart disease.

Conclusions:

  • Current clinical practice suggests minimal differences in mortality risk when using individual sulfonylureas in patients with heart failure.
  • The choice of sulfonylurea among the studied agents is unlikely to significantly impact mortality outcomes in this patient population.
Abstract

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