Cardiovascular Endocrinology

Skip Navigation LinksHome > December 2014 - Volume 3 - Issue 4 > Does dipeptidyl peptidase IV inhibitor increase the risk of...
Text sizing:
Cardiovascular Endocrinology:
doi: 10.1097/XCE.0000000000000036

Does dipeptidyl peptidase IV inhibitor increase the risk of heart failure? A cardiologist’s paradox

Kanakia, Rushita; Martinho, Shaunc; Patel, Tejasa; Arain, Faisal A.a; Panday, Manoj M.b; Le Saux, Claude J.b; Pham, Son V.b; Bailey, Steven R.a; Chilton, Roberta

Collapse Box


Diabetes patients have a higher burden of cardiovascular disease compared with the general population. In addition, type 2 diabetes portends a very high risk for major adverse cardiovascular events. The SAVOR trial showed that patients with documented type 2 diabetes and a previous history of, or risk factors for, cardiovascular disease had a 1-year cardiovascular event rate of 2–3%. Whereas in the EXAMINE trial, type 2 diabetes patients with acute coronary syndrome had a 1-year event rate between 6 and 7% after revascularization. Both of these prospective trials used new dipeptidyl peptidase IV (DPP-4) inhibitors as the treatment modality. Clinically, this class of compounds is extremely well tolerated by patients. The new DPP-4 inhibitors were promising from previous meta-analyses at reducing cardiovascular outcomes. In this article, we review literature on the cardiovascular outcomes with oral hypoglycemic agents, focusing on the two recent, large prospective trials on DDP-4 inhibitors. It is important to recognize that these trials enrolled different patients. The SAVOR trial had type 2 diabetes patients (>40 years old) with established cardiovascular disease or multiple cardiovascular risk factors, whereas EXAMINE trial had type 2 diabetes patients (>18 years old) 15–90 days postrevascularization for acute coronary syndrome. The primary cardiovascular endpoint was a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Neither trial showed a significant cardiovascular benefit. However, neither trial showed increased cardiovascular mortality.

© 2014Wolters Kluwer Health Lippincott Williams Wilkins


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.