Do DPP-4 Inhibitors Harm Patients with T2DM and Heart Failure?
the MPR take:
Patients with type 2 diabetes (T2D) and a history of heart failure (HF) taking sitagliptin have a greater risk of HF-related hospitalizations, but not all-cause hospitalizations or mortality. This population-based retrospective cohort study in JACC Heart Failure reviewed a national commercially insured U.S. claims database on 7,620 patients with T2D and incident HF. Sitagliptin users were not found to be at an increased risk of all-cause hospital admission or death; however, sitagliptin use was associated with an increased risk of HF hospitalizations in patients with pre-existing HF and T2D (12.5% vs. 9.0%, aOR: 1.84, 95% CI: 1.16–2.92). Physicians prescribing sitagliptin to T2D patients with a history of HF should carefully monitor these patients for HF-related complications.
The cardiovascular effects of drugs used for glucose control in patients with diabetes have been a subject of controversy for many years now. More recently, attention has started to focus specifically on the risk for heart failure. Now, an observational study will likely raise new questions about the dipeptidyl peptidase (DPP)-4 inhibitor sitagliptin (Januvia, Merck).
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