title: Oral hypoglycaemic agents and the development of non-fatal cardiovascular events in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  This study aimed to assess the risk of non-fatal cardiovascular events among patients with type 2 diabetes mellitus (T2DM) who are taking metformin, glimepiride or glyburide.
  
  
  METHODS
  Using the National Health Insurance Research database in Taiwan, this retrospective cohort study identified 1159 patients with newly diagnosed T2DM from 1998 to 2007, 30 years and older and without a history of cardiovascular disease at baseline. Patients with cancer, liver cirrhosis or chronic kidney disease were excluded. On the basis of prescription, patients were grouped into three medication subcohorts: metformin (N = 595), glimepiride (N = 234) or glyburide (N = 330) monotherapy for 100% of the follow-up period without any oral anti-diabetic agents added or changed, by the end of 2009. Incidence and hazard ratios of non-fatal cardiovascular events including coronary artery disease, peripheral artery disease, stroke and heart failure among these three subcohorts were compared.
  
  
  RESULTS
  The overall incidence of non-fatal cardiovascular events was the highest for patients taking glyburide (169.1 per 1000 person-years), followed by for those taking glimepiride and metformin (95.2 and 49.1 per 1000 person-years, respectively). Compared with the adjusted hazard ratio for patients taking glyburide, the adjusted hazard ratio for those taking glimepiride was 0.52 (95% CI 0.40-0.69) and for those taking metformin was 0.31 (95% CI 0.24-0.40).
  
  
  CONCLUSIONS
  T2DM patients taking metformin and glimepiride are at lower risk of non-fatal cardiovascular events than those taking glyburide.
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung, 40447, Taiwan; Department of Internal Medicine, China Medical University, Taichung, 40447, Taiwan.
authors: Yi-Chih
authors: YC
authors: Hung
authors: Che-Chen
authors: CC
authors: Lin
authors: Tzu-Yuan
authors: TY
authors: Wang
authors: Man-Ping
authors: MP
authors: Chang
authors: Fung-Chang
authors: FC
authors: Sung
authors: Ching-Chu
authors: CC
authors: Chen
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003327:Coronary Disease; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology*; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005905:Glyburide / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D013624:Taiwan / Q000453:epidemiology
chemical_list: D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; C057619:glimepiride; D008687:Metformin; D005905:Glyburide
keywords: cardiovascular events; metformin; sulfonylurea; type 2 diabetes mellitus