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Glimepiride Use is Associated with Reduced Cardiovascular Mortality in Patients with Type 2 Diabetes and Chronic

Wu He1, Gang Yuan2, Yu Han1

  • 1Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan 430030, China.

European Journal of Preventive Cardiology
|December 27, 2022
PubMed

Insights

Glimepiride use in type 2 diabetes patients with chronic heart failure significantly reduces mortality and hospitalizations. High-dose glimepiride offers greater cardiovascular protection, potentially via increased epoxyeicosatrienoic acid levels.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Glimepiride demonstrates favorable cardiovascular safety.
  • Clinical benefits of glimepiride on cardiovascular outcomes in patients with type 2 diabetes and chronic heart failure remain unclear.

Purpose of the Study:

  • To investigate the association between glimepiride use and clinical cardiovascular outcomes in patients with type 2 diabetes (T2D) and chronic heart failure (CHF).

Main Methods:

  • Analysis of 21,451 inpatients with T2D and CHF, comparing 638 glimepiride users to 20,813 non-users.
  • Propensity score matching created 509 pairs for analysis.
  • Kaplan-Meier and Cox regression analyses assessed mortality, heart failure events, myocardial infarction, and stroke.

Main Results:

  • Glimepiride use was linked to significantly lower all-cause mortality (aHR, 0.47), cardiovascular mortality (aHR, 0.34), heart failure events (aHR, 0.42), and acute myocardial infarction/stroke hospitalizations (aHR, 0.53).
  • High-dose glimepiride (2-4 mg/day) showed greater cardiovascular protection than low-dose (1 mg/day).
  • Glimepiride demonstrated molecular docking with soluble epoxide hydrolase (sEH) and increased epoxyeicosatrienoic acid (EET) levels.

Conclusions:

  • Long-term glimepiride use improves survival and reduces cardiovascular events in T2D patients with CHF.
  • Higher glimepiride doses provide enhanced cardiovascular benefits.
  • The cardioprotective effects may involve increased EET levels via sEH inhibition.
Abstract

Keywords:
Cardiovascular mortalityChronic heart failureGlimepirideMortalityType 2 diabetes

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