ArticleBMJ open2015
Hospitalisation for heart failure and mortality associated with dipeptidyl peptidase 4 (DPP-4) inhibitor use in an unselected population of subjects with type 2 diabetes: a nested case-control study.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Incretin based treatments and mortality in patients with type 2 diabetes: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2017Pooled it
- Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis.Diabetes & vascular disease researchPooled it
- Clinical aspects of heart failure in individuals with diabetes.Diabetologia · 2019Review
- The pleiotropic cardiovascular effects of dipeptidyl peptidase-4 inhibitors.British journal of clinical pharmacology · 2018Review
- Current perspectives on cardiovascular outcome trials in diabetes.Cardiovascular diabetology · 2016Review
- Treating Diabetes in Patients with Heart Failure: Moving from Risk to Benefit.Current heart failure reports · 2016Review
- PERS&O (PERsistent Sitagliptin treatment & Outcomes): observational retrospective study on cardiovascular risk evolution in patients with type 2 diabetes on persistent sitagliptin treatment.BMJ open diabetes research & care · 2016Article
- Insights from cardiovascular outcome trials with novel antidiabetes agents: what have we learned? An industry perspective.Current diabetes reports · 2015Review
- Utility of Saxagliptin in the Treatment of Type 2 Diabetes: Review of Efficacy and Safety.Advances in therapy · 2015Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe SAVOR TIMI-53 study reported a significant increase in the risk of hospitalisation for heart failure (HF) in patients treated with a DPP-4 inhibitor (DPP-4i) in comparison with placebo. A recent case-control study in part confirmed this risk signal. Our aim was to compare the occurrence of HF in relation to DPP-4i use versus any antidiabetic treatment.
designPopulation-based matched case-control study conducted using administrative data.
settingThe Italian Region of Piedmont (4.4 million inhabitants).
participantsFrom a database of 282,000 patients treated with antidiabetic drugs, we identified 14,613 hospitalisations for HF, 7212 incident cases, and 1727 hospital re-admissions between 2008 and 2012; each case was matched for gender, age and antidiabetic therapy with 10 controls; cases and controls were compared for exposure to DPP-4i. OUTCOME MEASURES: ORs and 95% CIs were calculated by fitting a conditional logistic model. All analyses were adjusted for available risk factors for HF.
resultsWe found no increased risk of hospitalisation for HF associated with the use of DPP-4i (OR for admission for HF 1.00 (0.94 to 1.07), incident HF1.01 (0.92 to 1.11), recurrent HF 1.02 (0.84 to 1.22)). All-cause mortality was 6% lower in DPP-4i users (p<0.001), whereas insulin users showed an excess of risk for any type of hospital admission (19%) and death (20%) (p<0.001).
conclusionsOur findings suggest that, in an unselected population of diabetic patients, the use of DPP-4i is not associated with an increased risk of HF. The favourable impact on all-cause mortality should be viewed with caution and also other explanations investigated.
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