Overview

• The analysis used electronic health records and claims data from 48,165 patients with type 2 diabetes and moderate cardiovascular risk treated at 10 U.S. sites between 2014 and 2022.
• Emulating a randomized trial, researchers found glipizide was associated with a 13% relative increase in five-year risk of major adverse cardiovascular events compared with DPP-4 inhibitors.
• Major adverse events encompassed myocardial infarction, ischemic stroke, heart failure hospitalization and cardiovascular death.
• In contrast, glimepiride showed a smaller effect and glyburide’s association with cardiovascular outcomes was statistically inconclusive.
• The study highlights the importance of drug-specific cardiovascular risk assessment and calls on clinicians to balance affordability with safety while further research probes underlying mechanisms.