Abstract 11751: Beneficial Impact of Dipeptidyl-peptidase-4 inhibitors on Mortality of Patients With Hospitalized Heart Failure Patients With Diabetes Mellitus

Abstract

Background: Heart failure (HF) and diabetes mellitus (DM) often co-exist. Treatment of DM in patients with HF is challenging since some therapies for DM are contraindicated in HF. Although previous experimental studies have reported that DPP-4 inhibitors improve cardiovascular function, it still remains unclear whether DPP-4 inhibition improves mortality of HF patients with DM. Therefore, we examined impacts of the DPP-4 inhibition on mortality in hospitalized HF patients using propensity score matching. Methods and Results: We performed prospective observational study regarding to hospitalized HF. Out of 1011 original HF patients cohort, 112 patients were treated with DPP-4 inhibitors. Propensity score for treatment with DPP-4 inhibitors were estimated for each patient by logistic regression with clinically relevant baseline variables including age, estimated GFR, HbA1c, usages of α-glucosidase inhibitor, sulphonylurea, biguanide and insulin. The propensity matched cohort 1:1 was assessed based on propensity scores (DPP-4 inhibitors, n = 82 and non-DPP-4 inhibitors, n = 82). Kaplan-Meier analysis demonstrated that cardiac and all-cause mortality was significantly lower in the DPP-4 inhibitor group than in the non-DPP-4 inhibitor group (cardiac mortality: 7.3% vs. 23.2%, P=0.006; all-cause mortality: 17.1% vs. 42.7%, P=0.002, by a log-rank test) in the propensity matched cohort. In the multivariable Cox proportional hazard analyses, after adjusting for other potential confounding factors, the use of DPP-4 inhibitors was an independent predictor of cardiac and all-cause mortality (cardiac mortality: HR 0.322, 95% CI 0.127-0.819, P = 0.017; all-cause mortality: HR 0.517, 95% CI 0.273-0.978, P = 0.042) in HF patients with DM. Conclusions: Our data suggest that DPP-4 inhibitors may improve cardiac and all-cause mortality in patients with HF and DM.