title: Comparative cardiovascular safety of insulin secretagogues following hospitalization for ischemic heart disease among type 2 diabetes patients: a cohort study.
abstract: OBJECTIVE
  To evaluate the association between insulin secretagogues and adverse cardiovascular sequelae in type 2 diabetes patients hospitalized for ischemic heart disease (IHD).
  
  
  METHODS
  Administrative health records from Alberta, Canada between 1998 and 2010 were used to identify 2,254 gliclazide, 3,289 glyburide and 740 repaglinide users prior to an IHD-related hospitalization. Multivariable Cox regression models were used to compare the 30-day risk of a composite outcome of all-cause mortality or new onset of atrial fibrillation, stroke, heart failure or myocardial infarction according to insulin secretagogue use.
  
  
  RESULTS
  Mean (SD) age was 76.1 (6.9) years, and 60.7% were men. The composite outcome occurred in 322 (30.2%) gliclazide users, 455 (28.1%) glyburide users and 81 (23.4%) repaglinide users within 30 days of IHD hospitalization. There were no differences in risk for glyburide use (adjusted hazard ratio [aHR] 0.91; 95% confidence interval [CI] 0.78-1.05) or repaglinide use (aHR 0.80; 95% CI 0.63-1.03) compared to gliclazide. Similar results were observed in analyses for each element of the composite outcome.
  
  
  CONCLUSIONS
  In older patients with type 2 diabetes hospitalized for IHD, prior use of gliclazide, glyburide, or repaglinide appears to be associated with a similar risk of adverse cardiovascular sequelae.
authors.affiliation: Department of Biochemistry, Faculty of Medicine and Dentistry, University of Alberta, 8440 122St. NW, Edmonton, Alberta, Canada, T6G 2R7. Electronic address: yuhao7@ualberta.ca.
authors.forename: Yuhao
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 11405 87 Ave. NW,St. Edmonton, Alberta, Canada, T6G 1C9. Electronic address: aabdelmo@ualberta.ca.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Abdelmoneim
authors.affiliation: Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, 8440 122St. NW, Edmonton, Alberta, Canada, T6G 2R7. Electronic address: plight@ualberta.ca.
authors.forename: Peter
authors.initials: P
authors.lastname: Light
authors.affiliation: School of Public Health, University of Alberta, 11405-87 Ave, Edmonton, Alberta, Canada, T6G 1C9. Electronic address: weiyu@ualberta.ca.
authors.forename: Weiyu
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 11405 87 Ave. NW,St. Edmonton, Alberta, Canada, T6G 1C9. Electronic address: scot@ualberta.ca.
authors.forename: Scot H
authors.initials: SH
authors.lastname: Simpson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D054598:Blue Cross Blue Shield Insurance Plans; D002219:Carbamates / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D058065:Diabetic Cardiomyopathies / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D005907:Gliclazide / Q000009:adverse effects / Q000627:therapeutic use; D005905:Glyburide / Q000009:adverse effects / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000401:mortality / Q000628:therapy; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D019472:Universal Health Insurance
chemical_list: D002219:Carbamates; D007004:Hypoglycemic Agents; D010880:Piperidines; C072379:repaglinide; D005907:Gliclazide; D005905:Glyburide
keywords: Atrial fibrillation; Insulin secretagogue; Ischemic heart disease; Retrospective cohort study; Type 2 diabetes