Dipeptidyl Peptidase-4 Inhibitors and Cardiovascular Risk: Retrospective Study of 50 Type 2 Diabetic Patients with Chronic Heart Failure

Objectives: The choice of antidiabetics in patients with heart failure is a major clinical concern. Some antidiabetic agents such as thiazolidinediones, more or less sulfonamides and insulin increase the risk of exacerbation of heart failure. There is controversy with regard to the cardiovascular risk associated with dipeptidyl peptidase-4 (DPP-4) inhibitors. The aim of this study was to evaluate the cardiovascular risk in patients with diabetes and heart failure treated with these medications.

Patients and methods: A retrospective study was carried out from January 2014 to April 2015 at the Centre Hospitalier de Haguenau. The frequency of re-hospitalizations was studied (primary endpoint), as the duration of hospitalization and death in patients with type 2 diabetes and heart failure. Patients were divided into 2 groups, those treated with DPP-4 inhibitors (cases) and those not treated with DPP-4 inhibitors (controls).

Results: Fifty regularly followed up type 2 diabetic patients with chronic heart failure were included in this study, of whom 32(64%) were men. Their mean age (SD) was 73.7 (± 7.6) years, ranging between 58 and 85 years. Twenty-four cases (48%) were treated with DPP-4 inhibitors. The rate of re-hospitalizations (primary endpoint) was 33.3% in the cases, and 26.9% in the controls (OR: 1.29, CI: 0.38 – 4.35, p=0.575). The duration of first hospitalization was 11.9 (±8.3) days in the cases, and 9.1 (±6.2) days in the controls (Risk ratio: 1.31, p=0.217). In-hospital mortality was not different between the 2 groups.

Conclusion: Treatment with DPP-4 inhibitors was not associated with an increased risk of re-hospitalizations, duration of hospitalizations, and death in type 2 diabetic patients with heart failure.