Abstract
Oral anti-diabetic agents have been associated with adverse cardiovascular events in type 2 diabetes (DM2). We investigated the risk of coronary artery disease (CAD), congestive heart failure (CHF), and mortality using multivariable Cox models in a retrospective cohort of 20,450 DM2 patients from our electronic health record (EHR). We observed no differences in CAD risk among the agents. Metformin was associated with a reduced risk of CHF (HR 0.76, 95% CI 0.64–0.91) and mortality (HR 0.54, 95% CI 0.46–0.64) when compared to sulfonylurea. Pioglitazone was also associated with a lower risk of mortality when compared to sulfonylurea (HR 0.59, 95% CI 0.43–0.81). No other significant differences were found between the oral agents. In conclusions, our results did not identify an increased CAD risk with rosiglitazone in clinical practice. However, the results do reinforce a possible increased risk of adverse events in DM2 patients prescribed sulfonylureas.
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Acknowledgments
The study was supported through a research grant from Astra Zeneca (Dr. Kattan). Dr. Michael W. Kattan had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Conflict of interest statement
R.S. Zimmerman Consultancies: Daiichi Sankyo, Merck, Pfizer, Novo Nordisk, and GlaxoSmithKline. Grants received: Michael W. Kattan, Anil Jain, and Ashish Atreja (Astra Zeneca). Dr. Kevin Pantalone, Dr. Brian Wells, Changhong Yu, and Susana Arrigain report no conflicts of interest.
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Pantalone, K.M., Kattan, M.W., Yu, C. et al. The risk of developing coronary artery disease or congestive heart failure, and overall mortality, in type 2 diabetic patients receiving rosiglitazone, pioglitazone, metformin, or sulfonylureas: a retrospective analysis. Acta Diabetol 46, 145–154 (2009). https://doi.org/10.1007/s00592-008-0090-3
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DOI: https://doi.org/10.1007/s00592-008-0090-3