The impact of DPP-4 inhibitors on long-term survival among diabetic patients after first acute myocardial infarction.

Abstract

BACKGROUND:

Previous studies regarding the cardioprotective effects of dipeptidyl peptidase 4 (DPP-4) inhibitors have not provided sufficient evidence of a relationship between DPP-4 inhibition and actual cardiovascular outcomes. This study aimed to evaluate the impact of DPP-4 inhibitors on the survival of diabetic patients after first acute myocardial infarction (AMI).

METHODS:

This was a nationwide, propensity score-matched, case-control study of 186,112 first AMI patients, 72,924 of whom had diabetes. A propensity score, one-to-one matching technique was used to match 2672 controls to 2672 patients in the DPP-4 inhibitor group for analysis. Controls were matched based on gender, age, and a history of hypertension, dyslipidemia, diabetes, peripheral vascular disease, heart failure, cerebrovascular accident, end-stage renal disease, chronic obstructive pulmonary disease, and percutaneous coronary intervention.

RESULTS:

DPP-4 inhibitors improve the overall 3-year survival rate (log rank P < 0.0001), whether male or female. Cox proportional hazard regression showed DPP-4 inhibitor is beneficial in diabetes patients after AMI (HR = 0.86; 95% CI 0.78-0.95), especially in those patients with hypertension (HR = 0.87; 95% CI 0.78-0.97; P = 0.0103) and cerebrovascular disease (HR = 0.83; 95% CI 0.72-0.97; P = 0.018), but without dyslipidemia (HR = 0.78; 95% CI 0.67-0.92; P = 0.0029), without peripheral vascular disease (HR = 0.86; 95% CI 0.78-0.96; P = 0.0047), without heart failure (HR = 0.84; 95% CI 0.73-0.96; P = 0.0106), without end stage renal disease (HR = 0.86; 95% CI 0.77-0.95; P = 0.0035), and without chronic obstructive pulmonary disease (HR = 0.87; 95% CI 0.78-0.97; P = 0.0096).

CONCLUSIONS:

DPP-4 inhibitor therapy improved long-term survival in diabetic patients after first AMI, regardless of gender.

• Authors: Mei-Tzu Wang, Sheng-Che Lin, Pei-Ling Tang, Wang-Ting Hung, Chin-Chang Cheng, Jin-Shiou Yang, Hong-Tai Chang, Chun-Peng Liu, Guang-Yuan Mar, Wei-Chun Huang
• Journal: Cardiovascular diabetology (Cardiovasc Diabetol) Vol. 16 Issue 1 Pg. 89 (07 11 2017) ISSN: 1475-2840 [Electronic] England
• PMID: 28697774 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Dipeptidyl-Peptidase IV Inhibitors
• Hypoglycemic Agents

Topics

• Aged
• Aged, 80 and over
• Case-Control Studies
• Diabetes Mellitus, Type 2 (complications, drug therapy, mortality)
• Dipeptidyl-Peptidase IV Inhibitors (therapeutic use)
• Female
• Heart Failure (complications, drug therapy, mortality)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Kidney Failure, Chronic (drug therapy)
• Male
• Middle Aged
• Myocardial Infarction (complications, drug therapy, mortality)
• Percutaneous Coronary Intervention (methods)
• Time