Sulfonylurea therapies may increase risk of CVD events in older patients with type 2 diabetes
MONDAY, June 27 (HealthDay News) -- Initial antihyperglycemic treatment with sulfonylurea (SU) monotherapy may result in earlier and increased incidents of cardiovascular disease (CVD) than treatment with metformin (MET) in older patients with type 2 diabetes (T2DM), according to a study presented at the American Diabetes Association's 71st Scientific Sessions, held from June 24 to 28 in San Diego.
Alex Z. Fu, Ph.D., from the Cleveland Clinic, and colleagues investigated the correlation between initial monotherapy with an SU or MET and subsequent CVD in 8,502 patients (average age, 75 years) with T2DM. The participants, who were controlled for differences in baseline characteristics, received their first prescription of either SU or MET monotherapy between 2003 and 2007, continued with it for at least 90 days, and had at least two years of follow-up after the first prescription.
The investigators found that, after two years of follow-up, patients who started with an SU had a significantly higher incidence of CVD events compared to those initiated with MET (12.4 versus 10.4 percent). The difference was primarily due to an increased incidence of ischemic heart disease with an SU compared to MET (7.2 versus 5.5 percent). The probability of having a CVD event was higher in patients initiated with an SU (odds ratio, 1.23) and correlated with a shorter time to first CVD event (hazard ratio, 1.15). Sensitivity analyses after one- or three-year follow-up showed similar results.
"In a cohort of older patients with T2DM initiating antihyperglycemic therapy, the likelihood of experiencing a CVD event was higher and these events occurred sooner in patients who started with SU monotherapy than those who started with MET," the authors write.