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Cardiovascular safety of sulfonylurea has been questioned by some authors. This article aims at collecting all available data on this issue from randomized trials.

A meta‐analysis was performed including all trials with a duration of at least 6 months, comparing a sulfonylurea with a non‐sulfonylurea agent in type 2 diabetes. Major cardiovascular events (MACE) and mortality were retrieved and combined to calculate Mantel‐Haenzel odds ratio (MH‐OR).

Of the 115 selected trials, 62 reported information on MACE, and 30 reported at least one event. MH‐OR for sulfonylurea was 1.08 [0.86–1.36], p = 0.52 (1.85 [1.20–2.87], p = 0.005, in the five trials vs. DPP4 inhibitors, no significant differences vs. other comparators). The MH‐OR for myocardial infarction and stroke was 0.88 [0.75–1.04], p = 0.13 and 1.28 [1.03–1.60], p = 0.026, respectively. Mortality was significantly increased with …