Two drugs commonly used for oral treatment of diabetes are equally safe for patients who have been hospitalized for acute myocardial infarction (AMI) or underwent percutaneous coronary intervention (PCI), according to new research conducted at the Institute for Clinical Evaluative Sciences (ICES).
Diabetes affects approximately 200 million people worldwide, including more than a quarter of those aged 65 and older in developed nations. For many years, scientists have been concerned that the oral diabetes drug glyburide, used by millions of people worldwide, might be associated with adverse cardiac events because it interferes with a beneficial process known as "ischemic preconditioning,” in which heart muscle gradually adapts to low oxygen supply. Newer drugs from the same class, such as gliclazide, do not do this.
“We studied patients who were hospitalized for AMI or who underwent PCI while receiving either glyburide or gliclazide and found no difference in the future risk of cardiac events in patients receiving glyburide,” says Dr. David Juurlink, scientist at ICES and lead author on the study.
The population-based cohort study of patients aged 66 years and older who were hospitalized for AMI or underwent PCI while receiving either glyburide or gliclazide in Ontario between April 1, 2007 and March 31, 2010 found:
- 1690 patients treated with glyburide were matched to 984 patients treated with gliclazide at the time of hospitalization for AMI or PCI.
- Treatment with glyburide was not associated with an increased risk of future adverse cardiovascular events relative to gliclazide.
“Overall these findings provide a measure of reassurance about the cardiac safety of glyburide for older patients with diabetes,” says Dr. Baiju Shah, co-author, ICES scientist and endocrinologist.
Authors: David N. Juurlink, Tara Gomes, Baiju R. Shah and Muhammad M. Mamdani.
The study “Adverse cardiovascular events during treatment with glyburide or gliclazide in a high-risk population,” is in the current issue of Diabetic Medicine.
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.
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