Glyburide may be associated with a reduced risk of sudden cardiac arrest and ventricular arrhythmia (SCA/VA) when compared with glipizide. Findings from this retrospective cohort study were published in the journal Diabetes Care.

Using U.S. Medicaid claims (1999–2010) from 5 states, the researchers sought to examine the association between individual sulfonylureas (glyburide, glimepiride, glipizide) and outpatient-originating SCA/VA; glipizide was considered the reference exposure.

The study included 519,272 patients who used sulfonylureas. Of the total 176,889 person-years of sulfonylurea exposure, 632 SCA/VA events occurred (crude incidence rate 3.6 per 1,000 person-years). Half of these events resulted in immediate death. 

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Compared with glipizide, the propensity-score adjusted hazard ratios (HR) for SCA/VA were 0.82 (95% CI: 0.69–0.98) for glyburide and 1.10 (95% CI: 0.89–1.36) for glimepiride. Moreover, secondary analyses demonstrated a similar effect estimate for glyburide although not all confidence intervals excluded the null.

Based on these findings, the authors conclude that glyburide may carry a lower risk of SCA/VA incidence compared with glipizide. “This potential benefit must be contextualized by considering putative effects of different sulfonylureas on other cardiovascular end points, cerebrovascular end points, all-cause death, and hypoglycemia.”

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