Patients who take glyburide may be less likely than those receiving glipizide to experience sudden cardiac arrest (SCA) and ventricular arrhythmia (VA), according to a retrospective cohort study involving >500,000 individuals. Participants’ average age was 58 years. Investigators analyzed 1999–2010 Medicaid claims from 5 large states, looking at SCA/VA incidence in patients who took glyburide, glimepiride, or glipizide. Among the results:

• 632 SCA/VA events were seen in ~177,000 person-years of sulfonylurea exposure.
• >Half of the events were immediately fatal (3.6/1,000 person-years).
• Patients taking glyburide were 18% less likely to experience SCA/VA compared with those who took glipizide.
• Patients taking glimepiride were 10% more likely to experience such.

The authors noted that it is important to also consider the effects different sulfonylureas have on other cardiovascular and cerebrovascular outcomes, all-cause death, and hypoglycemia.