Comparative cardiovascular risk of sulfonylureas with low‐ and high‐affinities for cardiac mitochondrial adenosine triphosphate‐sensitive potassium channels versus dipeptidyl peptidase‐4 inhibitors in patients with type 2 diabetes: A cohort study
Main finding · 3-point MACEResult — go to the resultHazard ratio 1.01 95% CI 0.96–1.06Authors' conclusion
Initiating low-affinity mitoKATP-channel sulfonylureas demonstrated cardiovascular safety comparable to DPP-4i, whereas high-affinity sulfonylureas were linked to increased cardiovascular risk and all-cause mortality. These findings suggest low-affinity sulfonylureas are a safer alternative to high-affinity agents and as safe as DPP-4i. They may be appropriate for individuals with diabetes when newer therapies are inaccessible or unnecessary.
Study context
- Population
- New users with T2D, Taiwan's nationwide claims database (2012–2022), excluding recent pre-entry cardiovascular events; mean age 60.2 years, 55.6% male
- Participants
- 466,158 / 83,031 / 473,539
- Exposure
- Low-affinity and high-affinity mitoKATP-channel SU vs DPP-4i
- Low-affinity SUn = 466,158
- High-affinity SUn = 83,031
- DPP-4in = 473,539reference
- Outcome
- 3-point MACE: ischaemic stroke, MI, cardiovascular death
Methodological detailsnew user, active comparator, propensity score-based inverse probability of treatment weighting, nationwide claims database
- New user
- Active comparator
- Propensity score-based inverse probability of treatment weighting
- Nationwide claims database
Main finding
3-point MACE
Hazard ratio
1.01
95% CI 0.96–1.06
Low-affinity SUvs DPP-4i
HR 1.01 (95% CI 0.96–1.06)
As reported in the abstract
- High-affinity SU vs DPP-4i: increased risks of 3-point MACE, cardiovascular death and all-cause mortality
- 1.17-1.31-fold
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| Cardiovascular deathLow-affinity SUvs DPP-4i | 1.01 (0.93–1.08) | |
| All-cause mortalityLow-affinity SUvs DPP-4i | 0.97 (0.93–1.01) | |
| 0.512Hazard ratio (log scale) |
Original publication
Comparative cardiovascular risk of sulfonylureas with low‐ and high‐affinities for cardiac mitochondrial adenosine triphosphate‐sensitive potassium channels versus dipeptidyl peptidase‐4 inhibitors in patients with type 2 diabetes: A cohort study. Diabetes Obes Metab. Published 29 September 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →