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.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Angiotensin-Converting Enzyme Inhibitors / therapeutic use
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Coronary Artery Bypass
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Coronary Disease / epidemiology*
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Coronary Disease / mortality
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Coronary Disease / surgery
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Diabetes Mellitus, Type 2 / complications
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Diabetes Mellitus, Type 2 / drug therapy*
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Diabetic Angiopathies / epidemiology*
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Diabetic Angiopathies / mortality
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Female
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Heart Failure / epidemiology*
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Heart Failure / mortality
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Humans
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Hypoglycemic Agents / adverse effects
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Hypoglycemic Agents / therapeutic use*
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Male
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Metformin / adverse effects
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Metformin / therapeutic use
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Multivariate Analysis
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Proportional Hazards Models
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Retrospective Studies
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Risk Factors
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Rosiglitazone
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Smoking / epidemiology
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Sulfonylurea Compounds / adverse effects
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Sulfonylurea Compounds / therapeutic use
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Survival Analysis
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Survivors
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Thiazolidinediones / adverse effects
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Thiazolidinediones / therapeutic use
Substances
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Angiotensin-Converting Enzyme Inhibitors
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Hypoglycemic Agents
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Sulfonylurea Compounds
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Thiazolidinediones
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Rosiglitazone
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Metformin