Key result
Sulfonylurea linked to ~90% higher risk of ventricular arrhythmia or sudden cardiac death vs metformin.
Why the study?
Commonly prescribed diabetic medications such as metformin and sulfonylurea may have different arrhythmogenic risks, prompting a comparison of ventricular arrhythmia or sudden cardiac death risks between users.
Does sulfonylurea increase the risk of ventricular arrhythmia or sudden cardiac death compared to metformin in patients with type 2 diabetes?
Population
16 596 metformin users and 16 596 sulfonylurea users with type 2 diabetes in Hong Kong
Comparison
Sulfonylurea vs metformin
Design
Propensity score-matched population-based cohort study
Follow-up
Mean 4.92±2.55 years vs 4.93±2.55 years
Authors
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May support metformin preference over sulfonylureas; leaves open causality and needs randomized confirmation.
Cohort (n=33,192)
Does sulfonylurea increase the risk of ventricular arrhythmia or sudden cardiac death compared to metformin in patients with type 2 diabetes?
Hazard Ratio: 1.9 (95% CI 1.73–2.08)
In patients with type 2 diabetes, sulfonylurea use is associated with a nearly two-fold higher risk of ventricular arrhythmia or sudden cardiac death compared to metformin.
Lee et al. (2022) conducted a cohort in type 2 diabetes (n=33,192). Sulfonylurea vs. Metformin was evaluated on composite of ventricular arrhythmia or sudden cardiac death (HR 1.90, 95% CI 1.73-2.08). Sulfonylurea use was associated with a higher risk of ventricular arrhythmia or sudden cardiac death compared with metformin in patients with type 2 diabetes (HR 1.90; 95% CI 1.73-2.08).
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