Sitagliptin and the risk of hospitalization for heart failure: A population-based study

被引:54
作者
Wang, Kang-Ling [1 ,2 ,3 ,5 ]
Liu, Chia-Jen [3 ,5 ]
Chao, Tze-Fan [3 ,5 ]
Huang, Chi-Ming [5 ]
Wu, Cheng-Hsueh [3 ,5 ]
Chen, Su-Jung [3 ,5 ]
Yeh, Chiu-Mei [4 ]
Chen, Tzeng-Ji [4 ,7 ]
Lin, Shing-Jong [2 ,3 ,5 ,6 ]
Chiang, Chern-En [1 ,2 ,3 ,5 ,6 ]
机构
[1] Taipei Vet Gen Hosp, Gen Clin Res Ctr, Taipei, Taiwan
[2] Taipei Vet Gen Hosp, Dept Med Res, Taipei, Taiwan
[3] Taipei Vet Gen Hosp, Dept Med, Taipei, Taiwan
[4] Taipei Vet Gen Hosp, Dept Family Med, Taipei, Taiwan
[5] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan
[6] Natl Yang Ming Univ, Cardiovasc Res Ctr, Taipei 112, Taiwan
[7] Natl Yang Ming Univ, Inst Hosp & Hlth Care Adm, Taipei 112, Taiwan
关键词
Sitagliptin; Heart failure; Outcome research; DIPEPTIDYL PEPTIDASE-4 INHIBITORS; DIABETES-MELLITUS; CARDIOVASCULAR OUTCOMES; MYOCARDIAL-INFARCTION; GLYCEMIC CONTROL; GLUCOSE CONTROL; RATIONALE; TRIALS; ROSIGLITAZONE; COMPLICATIONS;
D O I
10.1016/j.ijcard.2014.09.038
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Saxagliptin was associated with an increased risk of hospitalization for heart failure (HHF) in diabetic patients with high cardiovascular risk. This study assessed the risk of HHF during an exposure to sitagliptin in general diabetic patients. Methods: In Taiwan National Health Insurance research database, a study of the beneficiaries aged >= 45 years with diabetes treated with or without sitagliptin between March 2009 and July 2011 was conducted. Patients treated with sitagliptin were matched to patients never exposed to a dipeptidyl peptidase-4 (DPP-4) inhibitor by the propensity score methodology. The outcome measures were the first and the total number of HHF, and mortality for heart failure or all causes. Results: A total of 8288 matched pairs of patients were analyzed. During a median of 1.5 years, the first event of HHF occurred in 339 patients with sitagliptin and 275 patients never exposed to a DPP-4 inhibitor (hazard ratio: 1.21, 95% confidence interval: 1.04-1.42, P = 0.017); all-cause mortality was similar (hazard ratio: 0.87, 95% confidence interval: 0.74-1.03, P = 0.109). The risk for HHF was proportional to exposure (hazard ratio: 1.09, 95% confidence interval: 1.06-1.11, P < 0.001 for every 10% increase in adherence to sitagliptin). Overall, there were 935 events of HHF, in which the association between the number of HHF and the adherence to sitagliptin was linear. The greatest total number of HHF occurred in the patients with the highest adherence. Conclusions: The use of sitagliptin was associated with a higher risk of HHF but no excessive risk for mortality was observed. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:86 / 90
页数:5
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