Is there a potential association between spironolactone and the risk of new-onset diabetes in a cohort of older patients with heart failure?
| Autor: | B. White-Guay, Simon de Denus, Sylvie Perreault, Sandra Korol, Marc Dorais, Michel White, Eileen O'Meara, Jean L. Rouleau, Ali Ahmed |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Spironolactone 030226 pharmacology & pharmacy Cohort Studies 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Risk Factors Diabetes mellitus Internal medicine medicine Diabetes Mellitus Glucose homeostasis Humans Pharmacology (medical) 030212 general & internal medicine Diuretics Aged Pharmacology Aged 80 and over Heart Failure Proportional hazards model business.industry Incidence (epidemiology) Incidence Hazard ratio Quebec General Medicine medicine.disease chemistry Cohort Female business Cohort study |
| Zdroj: | European journal of clinical pharmacology. 75(6) |
| ISSN: | 1432-1041 |
| Popis: | Some evidence suggests that spironolactone may have a deleterious effect on glucose homeostasis. The objective of this study was to assess whether spironolactone use is associated with a higher risk of developing diabetes in a large cohort of patients with heart failure (HF). Two Quebec government administrative databases were used to identify a cohort of hospitalized patients discharged between January 1995 and December 2009 with a primary discharge diagnosis of HF and without secondary discharge diagnosis of diabetes. Patients were categorized as new users of spironolactone and non-users. The primary outcome was defined as new-onset diabetes (NOD) during 5 years of follow-up and was ascertained using ICD codes for diabetes or use of hypoglycemic agents. Among the 2974 patients that were included in the cohort analysis, 769 were given a new prescription of spironolactone. The incidence rate of NOD was similar among spironolactone users (5.0 per 100 person-years) and non-users (4.9 per 100 person-years). There was no significant association between the use of spironolactone and NOD in the crude, unadjusted model (hazard ratio (HR) 1.01; 95% confidence interval (CI) 0.80–1.28; p = 0.9217), and it remained unchanged in the adjusted Cox proportional hazard model (HR = 0.92; 95% CI = 0.72–1.18; p = 0.5227). The results were consistent with those observed in sensitivity analyses of a 1:3 propensity score-matched cohort (HR = 0.97; CI = 0.76–1.25; p = 0.8169). We found no evidence supporting the claim that use of spironolactone is associated with a higher risk of diabetes among patients hospitalized for HF. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink