title: Comparable long-term mortality risk associated with individual sulfonylureas in diabetes patients with heart failure.
abstract: OBJECTIVE
  The aim was to investigate the outcomes of individual sulfonylureas in patients with heart failure (HF).
  
  
  METHODS
  All patients hospitalized with HF for the first time in 1997-2006, alive 30 days after discharge, and who received anti-diabetic monotherapy with glimepiride (n=1097), glibenclamide (glyburide) (n=1031), glipizide (n=557), gliclazide (n=251), or tolbutamide (n=541) were identified from nationwide registers. Risk of all-cause mortality was assessed by multivariable Cox regression models.
  
  
  RESULTS
  Over the median observational time of 744 (Inter Quartile Range 268-1451) days, 2242 patients (64%) died. The analysis demonstrated similar hazard ratio (HR) for mortality for treatment with glimepiride (1.10 [95% confidence interval 0.92-1.33]), glibenclamide (1.12 [0.93-1.34]), glipizide (1.14 [0.93-1.38]), tolbutamide (1.04 [0.85-1.26]), and gliclazide (reference). Grouped according to pancreatic specificity, i.e., with tolbutamide, glipizide, and gliclazide as specific, and glibenclamide, and glimepiride as non-specific agents, no differential prognosis was found between the two groups (HR 1.04 [0.96-1.14], for non-specific, compared to pancreas specific agents). The prognosis was not dependent on prior acute myocardial infarction or ischemic heart disease (p for interactions >0.3).
  
  
  CONCLUSIONS
  In current clinical practice, it is unlikely that there are considerable differences in risk of mortality associated with individual sulfonylureas in patients with heart failure.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Gentofte, Hellerup, Denmark. ca@heart.dk
authors.forename: Charlotte
authors.initials: C
authors.lastname: Andersson
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.forename: Casper H
authors.initials: CH
authors.lastname: Jørgensen
authors.forename: Peter R
authors.initials: PR
authors.lastname: Hansen
authors.forename: Allan
authors.initials: A
authors.lastname: Vaag
authors.forename: Rikke
authors.initials: R
authors.lastname: Sørensen
authors.forename: Charlotte
authors.initials: C
authors.lastname: Mérie
authors.forename: Jonas B
authors.initials: JB
authors.lastname: Olesen
authors.forename: Peter
authors.initials: P
authors.lastname: Weeke
authors.forename: Michelle
authors.initials: M
authors.lastname: Schmiegelow
authors.forename: Mette L
authors.initials: ML
authors.lastname: Norgaard
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D005913:Glipizide / Q000009:adverse effects / Q000627:therapeutic use; D005905:Glyburide / Q000009:adverse effects / Q000627:therapeutic use; D006333:Heart Failure / Q000139:chemically induced* / Q000401:mortality*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D013453:Sulfonylurea Compounds / Q000009:adverse effects* / Q000627:therapeutic use*; D014044:Tolbutamide / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; C057619:glimepiride; D014044:Tolbutamide; D005905:Glyburide; D005913:Glipizide