Cardiovascular effects of dipeptidyl peptidase-4 inhibitors in diabetic patients: A meta-analysis

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

“…Inhibitory dipeptylopeptydazy 4 (gliptyny), które zwiększają wydzielanie inkretyny i tym samym stymulują uwalnianie insuliny, a także długodziałający agoniści receptora glukagonopodobnego peptydu typu 1 (GLP-1), które działają jako inkretynomimetyki, poprawiają kontrolę glikemii, ale nie obniżają, a być może zwiększają ryzyko zdarzeń sercowo--naczyniowych i pogarszają HF [320,442,443] [130]. Przy braku innych badań obejmujących tę grupę leków nie można zakładać efektu klasy na podstawie danych na temat empagliflozyny.…”

Effect of dipeptidyl peptidase-4 inhibitors on heart failure: A meta-analysis of randomized clinical trials

“…However, only 54 studies were included into the data analysis while 4,098 studies were excluded. Reasons for exclusion were irrelevance or failure to meet inclusion/exclusion criteria (4,080), post-hoc analysis in nature (8) and data duplication (10). As a result, a total of 54 studies with 74,737 patients were included in the final analysis (9 with alogliptin [7,[21][22][23][24][25][26] A C C E P T E D M A N U S C R I P T…”

“…The studies by Wu et al and Monami et al were conducted with 24 and 37 studies, respectively. A recent meta-analysis by Savarese G. et al [10] was the largest meta-analysis, since there were 94 trials included in the analysis. However, the aim of that study was to evaluate the effect of DPP-4 inhibitors on various cardiovascular outcomes including all-cause and CV mortality, myocardial infarction, stroke and new onset of heart failure.…”

“…However, the aim of that study was to evaluate the effect of DPP-4 inhibitors on various cardiovascular outcomes including all-cause and CV mortality, myocardial infarction, stroke and new onset of heart failure. When examining the detail of studies included for heart failure evaluation of Savarese's study [10], the heart failure results of the study was in line with two previous meta-analyses [8,9]. Our analysis included the findings from a large new study which reported cardiovascular outcomes of sitagliptin in 14,000 patients who had pre-existing cardiovascular diseases or were at high risk for incidence of cardiovascular diseases (TECOS) [11], which is the largest-ever meta-analysis investigating the effect of DPP-4 inhibitors on heart failure to date.…”

The Management of Diabetic Patients with Heart Failure

“…Studies with DPP4i's have cast doubts about their safety in heart failure since earlier studies have shown an increased risk of heart failure in diabetic patients. [24,25] More recent data suggest that they may be safe to use but given their limited clinical benefit and given that there is a lack of data on their effect in patients with heart failure, their use is not recommended except under strict cardiology supervision. [12,26] Scanty data exist on the long-term safety of GLP1 receptor agonists and no data in patients with heart failure are available.…”