The Pharmaceutical Journal
Vol 273 No 7316 p337
11 September 2004

This article
Reprint   Photocopy

  Acrobat Reader

News summary

Old sulphonylureas have higher MI risk than newer agents

Treatment with “older” sulphonylureas is associated with twice the risk of a myocardial infarction than “newer” agents in this class (such as glimepiride and gliclazide), according to data presented at the European Association for the Study of Diabetes meeting this week.

The Danish case-control study matched 6,738 people having a first MI with age- and sex-matched controls, and assessed the rate of MI and deaths in relation to use of sulphonylureas. Results showed that the risk of MI was nearly three times as high in people using older sulphonylureas (odds ratio, 2.07) than newer agents (odds ratio, 1.36). The overall 30-day mortality rate was 24.6 per cent, reduced to 9.5 per cent in patients taking gliclazide.

The researchers suggested that older sulphonylureas block ATP-sensitive potassium channels in the heart, which prevents the myoprotective effects of ischaemic preconditioning — a process that can reduce damage to the heart during an MI.