Huang Yuhao, Abdelmoneim Ahmed S, Light Peter, Qiu Weiyu, Simpson Scot H
Department of Biochemistry, Faculty of Medicine and Dentistry, University of Alberta, 8440 122St. NW, Edmonton, Alberta, Canada, T6G 2R7.
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 11405 87 Ave. NW,St. Edmonton, Alberta, Canada, T6G 1C9.
J Diabetes Complications. 2015 Mar;29(2):196-202. doi: 10.1016/j.jdiacomp.2014.11.012. Epub 2014 Dec 2.
To evaluate the association between insulin secretagogues and adverse cardiovascular sequelae in type 2 diabetes patients hospitalized for ischemic heart disease (IHD).
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.
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.
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.
评估因缺血性心脏病（IHD）住院的2型糖尿病患者中胰岛素促泌剂与不良心血管后遗症之间的关联。
利用加拿大艾伯塔省1998年至2010年的行政健康记录，确定2254名在IHD相关住院治疗前使用格列齐特、3289名使用格列本脲和740名使用瑞格列奈的患者。采用多变量Cox回归模型，根据胰岛素促泌剂的使用情况，比较全因死亡率或新发房颤、中风、心力衰竭或心肌梗死复合结局的30天风险。
平均（标准差）年龄为76.1（6.9）岁，男性占60.7%。在IHD住院治疗的30天内，格列齐特使用者中有322人（30.2%）、格列本脲使用者中有455人（28.1%）、瑞格列奈使用者中有81人（23.4%）出现了复合结局。与格列齐特相比，使用格列本脲（调整后风险比[aHR]0.91；95%置信区间[CI]0.78 - 1.05）或瑞格列奈（aHR 0.80；95% CI 0.63 - 1.03）的风险没有差异。在对复合结局的每个要素进行分析时也观察到了类似的结果。
在因IHD住院的老年2型糖尿病患者中，先前使用格列齐特、格列本脲或瑞格列奈似乎与不良心血管后遗症的风险相似。
