Sulfonylureas and prognosis after myocardial infarction in patients with diabetes: a population-based follow-up study.
BACKGROUND
The cardiovascular safety, including risk of myocardial infarction (MI), of individual sulfonylureas (SUs) may differ. It remains uncertain whether treatment with individual SUs influences prognosis following MI.


METHODS
We conducted a nationwide population-based follow-up study among all Danish patients hospitalized with first-time MI from 1996 to 2004. From the national health databases, we identified 3930 MI patients who used SUs at the time of admission. We computed mortality rates and rates of MI and heart failure readmission according to type of SU and used Cox's proportional hazards regression analysis to compute hazard ratios (HRs) as estimates of relative risk controlling for differences in prognostic covariates.


RESULTS
The 30-day and 1-year mortality after MI among SU users was 22.0% and 35.3%, respectively. We found no substantial differences in 30-day and 1-year mortality among users of different SUs. Use of gliclazide in monotherapy showed a trend towards lower mortality; adjusted HR of 1-year mortality 0.70 (95% CI: 0.48-1.00). Users of the different SUs appeared to have similar risks of new MI and heart failure following MI.


CONCLUSIONS
The prognosis after MI was not substantially influenced by the choice of SU.
Horsdal
Henriette T
HT
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Johnsen
Søren Paaske
SP
Søndergaard
Flemming
F
Jacobsen
Jacob
J
Thomsen
Reimar W
RW
Schmitz
Ole
O
Sørensen
Henrik T
HT
Rungby
Jørgen
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D015983:Selection Bias; D018709:Statistics, Nonparametric; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D013997:Time Factors
D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds