Effects of Dipeptidyl Peptidase-4 Inhibitor on Cardiovascular Outcomes in Patients with Heart Failure with Preserved Ejection Fraction and Diabetes

Abstract

Introduction: Many pleiotropic effects of dipeptidyl peptidase 4 inhibitor (DPP4I) have been reported and expected to inhibit cardiovascular events. However, better prognostic value of DPP4I has not been proven in many clinical trials. Aim: The aim of this study was to investigate the effect of DPP4I on cardiovascular outcomes in Japanese patients with type 2 diabetes (DM) and heart failure (HF). Methods: Among prospectively enrolled 838 HF patients who were hospitalized for acute decompensated HF, 79 patients with DPP4I were compared with propensity score matched 79 control patients with DM. The primary endpoint was all cause mortality, and the secondary endpoint was a composite of cardiovascular death and hospitalization. Results: During follow up (423 ± 260 days), 8 deaths (10.1%) in DPP4I group and 13 (16.5%) in control group were occurred (log-rank, p=0.283). In patients with HF with preserved ejection fraction (n=75, LVEF ≧ 45%), DPP4I group showed better prognosis compare with control group in the primary endpoint (Figure A, log-rank, p=0.021) and tendency to be better prognosis in the secondary endpoint (log-rank, p=0.119). However, in patients with HF with reduced ejection fraction (n=83, LVEF Conclusion: DPP4I may be beneficial for cardiovascular outcomes in patients with DM and HF with preserved ejection fraction.