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Sulfonylurea is associated with higher risks of ventricular arrhythmia or sudden cardiac death compared with metformin: A population‐based cohort study

Lee, Teddy Tai Loy, Hui, Jeremy Man Ho, Lee, Yan Hiu Athena, Satti, Danish Iltaf, Shum, Yuki Ka Ling, Kiu, Pias Tang Hoi, Wai, Abraham Ka Chung, Liu, Tong, Wong, Wing Tak, Chan, Jeffrey Shi Kai, and others. (2022) Sulfonylurea is associated with higher risks of ventricular arrhythmia or sudden cardiac death compared with metformin: A population‐based cohort study. Journal of the American Heart Association, 11 (18). E-ISSN 2047-9980. (doi:10.1161/JAHA.122.026289) (KAR id:98707)

Abstract

Background

Commonly prescribed diabetic medications such as metformin and sulfonylurea may be associated with different arrhythmogenic risks. This study compared the risk of ventricular arrhythmia or sudden cardiac death between metformin and sulfonylurea users in patients with type 2 diabetes.

Methods and Results

Patients aged ≥40 years who were diagnosed with type 2 diabetes or prescribed antidiabetic agents in Hong Kong between January 1, 2009, and December 31, 2009, were included and followed up until December 31, 2019. Patients prescribed with both metformin and sulfonylurea or had prior myocardial infarction were excluded. The study outcome was a composite of ventricular arrhythmia or sudden cardiac death. Metformin users and sulfonylurea users were matched at a 1:1 ratio by propensity score matching. The matched cohort consisted of 16 596 metformin users (47.70% men; age, 68±11 years; mean follow‐up, 4.92±2.55 years) and 16 596 sulfonylurea users (49.80% men; age, 70±11 years; mean follow‐up, 4.93±2.55 years). Sulfonylurea was associated with higher risk of ventricular arrhythmia or sudden cardiac death than metformin hazard ratio (HR, 1.90 [95% CI, 1.73–2.08]). Such difference was consistently observed in subgroup analyses stratifying for insulin usage or known coronary heart disease.

Conclusions

Sulfonylurea use is associated with higher risk of ventricular arrhythmia or sudden cardiac death than metformin in patients with type 2 diabetes.

Item Type: Article
DOI/Identification number: 10.1161/JAHA.122.026289
Uncontrolled keywords: metformin; sudden cardiac death; sulfonylurea; type 2 diabetes; ventricular arrhythmia
Subjects: R Medicine > R Medicine (General)
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: University of Kent (https://ror.org/00xkeyj56)
Depositing User: Manfred Gschwandtner
Date Deposited: 05 Dec 2022 18:20 UTC
Last Modified: 05 Nov 2024 13:04 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/98707 (The current URI for this page, for reference purposes)

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