Role of previous treatment with sulfonylureas in diabetic patients with acute myocardial infarction: results from a nationwide French registry.
BACKGROUND
The cardiovascular effects of sulfonylureas (SU) in diabetic patients are controversial and it has been suggested that diabetic patients with acute myocardial infarction while on SU were at increased risk.


OBJECTIVE
To assess the in-hospital outcome of patients with acute myocardial infarction according to the use of SU at the time of the acute episode.


METHODS
Of 443 intensive care units in France, 369 (83%) prospectively collected all cases of infarction admitted within 48 h of symptom onset in November 2000.


RESULTS
Among the 2320 patients included in the registry, 487 (21%) had diabetes, of whom 215 (44%) were on SU. Patients on SU were older and had a more frequent history of hyperlipidemia than those not receiving SU. Type and location of infarction were similar in the two groups, and there was no difference in Killip class on admission. In-hospital mortality was lower in patients on SU (10.2%) than in those without SU (16.9%) (p = 0.035). There was a trend toward less frequent ventricular fibrillation (2.3% vs 5.9%, p = 0.052). In two models of multivariate analyses, SU therapy was associated with decreased in-hospital mortality (model 1: relative risk: 0.44, p = 0.012; model 2: relative risk: 0.37, p = 0.020).


CONCLUSIONS
In this nationwide registry reflecting real-world practice, the use of sulfonylureas in diabetic patients was not associated with increased in-hospital mortality.
Danchin
Nicolas
N
Service de Cardiologie, HEGP, Paris, France. nicolas.danchin@egp.ap-hop-paris.fr
Charpentier
Guillaume
G
Ledru
François
F
Vaur
Laurent
L
Guéret
Pascal
P
Hanania
Guy
G
Blanchard
Didier
D
Lablanche
Jean-Marc
JM
Genès
Nathalie
N
Cambou
Jean-Pierre
JP
D000368:Aged; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000503:physiopathology; D005260:Female; D005602:France; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology*; D012042:Registries; D015203:Reproducibility of Results; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds