Alberta Diabetes Institute, University of Alberta, 1-005 Li Ka Shing Centre for Health Research Innovation, Edmonton, Alberta, Canada.
Department of Pharmacology, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
Diabetes Obes Metab. 2024 Nov;26(11):5408-5419. doi: 10.1111/dom.15917. Epub 2024 Sep 9.
To examine the likelihood of mortality or rehospitalization following acute coronary syndrome with glyburide versus gliclazide use in adults with type 2 diabetes undergoing cardiac catheterization.
This retrospective cohort study used clinical data linked with administrative health data from Alberta, Canada between April 2008 and March 2021. Three methods were used to define exposure to glyburide and gliclazide in the year before catheterization. Multivariable logistic regression was used to compare the likelihood of a composite outcome of 1-year mortality or rehospitalization with use of glyburide versus use of gliclazide.
A total of 11 140 individuals with type 2 diabetes had a cardiac catheterization for acute coronary syndrome. Their mean age was 66 years and 31% were female. In the year before catheterization, 5% used glyburide and 19% used gliclazide. Any glyburide or gliclazide exposure in the year before catheterization was associated with a similar likelihood of all-cause mortality or rehospitalization (adjusted odds ratio [aOR] 1.14, 95% confidence interval [CI] 0.93-1.41; p = 0.20). However, current glyburide exposure (aOR 1.37, 95% CI 1.06-1.79; p = 0.018) and long exposure to glyburide (aOR 1.37, 95% CI 1.03-1.83; p = 0.030) were associated with a higher likelihood of the composite outcome compared to current and long exposure to gliclazide, respectively.
Current and long exposure to glyburide was associated with a greater likelihood of mortality or rehospitalization following cardiac catheterization for acute coronary syndrome, when compared to similar gliclazide exposure definitions. This study adds further evidence of the need to avoid using glyburide if a sulphonylurea is required for type 2 diabetes management.
在接受心脏导管检查的 2 型糖尿病成人中，比较使用格列本脲与格列吡嗪后发生急性冠脉综合征的死亡率或再住院率。
本回顾性队列研究使用了 2008 年 4 月至 2021 年 3 月期间加拿大艾伯塔省的临床数据与行政健康数据。使用三种方法在导管插入术前一年定义格列本脲和格列吡嗪的暴露情况。多变量逻辑回归用于比较使用格列本脲与使用格列吡嗪后 1 年死亡率或再住院率的复合结局的可能性。
共有 11140 例 2 型糖尿病患者因急性冠脉综合征接受了心脏导管检查。他们的平均年龄为 66 岁，31%为女性。在导管插入术前一年，5%的人使用格列本脲，19%的人使用格列吡嗪。导管插入术前一年的任何格列本脲或格列吡嗪暴露与全因死亡率或再住院率的可能性相似（调整后的优势比 [aOR] 1.14，95%置信区间 [CI] 0.93-1.41；p=0.20）。然而，当前的格列本脲暴露（aOR 1.37，95%CI 1.06-1.79；p=0.018）和长期的格列本脲暴露（aOR 1.37，95%CI 1.03-1.83；p=0.030）与该复合结局的可能性高于当前和长期的格列吡嗪暴露分别相关。
与类似的格列吡嗪暴露定义相比，当前和长期暴露于格列本脲与心脏导管检查后发生急性冠脉综合征的死亡率或再住院率增加有关。这项研究进一步证明了如果需要管理 2 型糖尿病，应避免使用格列本脲。
