Roumie CL, Chipman J, Min JY, et al. - In this retrospective cohort analysis, researchers compared treatment with metformin vs sulfonylurea in terms of major adverse cardiovascular events (MACE) in patients with diabetes and reduced kidney function (n = 49,478). Participants were US veterans obtaining care within the national Veterans Health Administration. These data were linked to Medicare, Medicaid, and National Death Index data from 2001 through 2016. Hospitalization for acute myocardial infarction, stroke, transient ischemic attack, or cardiovascular death, were included in MACE. For participants who received metformin vs sulfonylurea monotherapy, the incidence of MACE was estimated to be 23.0 per 1000 person-years vs 29.2 per 1000 person-years, a difference that was statistically significant. Overall, a lower risk of MACE was reported with metformin vs sulfonylurea treatment in patients with diabetes and reduced kidney function persisting with monotherapy.