Sitagliptin and the risk of hospitalization for heart failure in diabetic patients with chronic heart failure

[[abstract]]Objective: While saxagliptin is associated with hospitalization for heart failure (HF), the prognostic impact of Dipeptidyl peptidase-4 inhibitors (DPP4i) in diabetic patients with and without existed HF is yet determined. Methods: The study population, derived from the National Health Insurance Research Database of newly diagnosed type 2 diabetic subjects, comprised 32282 sitagliptin users and 32282 age-, sex, and HF history-matched non-users. Among them, 3680 subjects in each cohort had existed HF (CHF group) and 1203 subjects had been hospitalized for HF within the past year (AHF group) Results: Sitagliptin was clearly associated with higher rate for HF hospitalization in non-HF group, in CHF group and in AHF group. (Figure) With accounting for age, gender, hypertension, CAD, CKD, stroke, COPD, malignancy, and uses of sulfonyurea, bigluanide, α-glicosidase inhibitor, thiazolidinedione and insulin, Sitagliptin independently correlated with HF hospitlizaiton in non-HF group [HR and 95% CI: 1.56 (1.31–1.85)], in CHF group [1.72 (1.30–2.29)], and in AHF group [1.93 (1.59–2.35)]. With propensity score adjusting, sitagliptin remained an independent predictor for HF admission. The impact of DPP4 was increased along the order of non-HF subjects, CHF subjects, and AHF subjects with risk differences of 3, 16.2 and 96.94 per 1000 person-years (p-value for trend