Comparative Cardiovascular Risks of Dipeptidyl Peptidase-4 Inhibitors: Analyses of Real-world Data in Korea
- Author:
Kyoung Hwa HA
1
;
Bongseong KIM
;
Hae Sol SHIN
;
Jinhee LEE
;
Hansol CHOI
;
Hyeon Chang KIM
;
Dae Jung KIM
Author Information
- Publication Type:Original Article
- Keywords: Type 2 diabetes mellitus; Cardiovascular diseases; Dipeptidyl-peptidase IV inhibitors
- MeSH: Atrial Fibrillation; Cardiovascular Diseases; Comorbidity; Diabetes Mellitus, Type 2; Dipeptidyl-Peptidase IV Inhibitors; Dyslipidemias; Hypertension; Infarction; Korea; Linagliptin; National Health Programs; Platelet Aggregation Inhibitors; Proportional Hazards Models; Renal Insufficiency, Chronic; Sitagliptin Phosphate; Stroke
- From:Korean Circulation Journal 2018;48(5):395-405
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: To compare cardiovascular disease (CVD) risk associated with 5 different dipeptidyl peptidase-4 inhibitors (DPP-4is) in people with type 2 diabetes. METHODS: We identified 534,327 people who were newly prescribed sitagliptin (n=167,157), vildagliptin (n=67,412), saxagliptin (n=29,479), linagliptin (n=220,672), or gemigliptin (n=49,607) between January 2013 and June 2015 using the claims database of the Korean National Health Insurance System. A Cox proportional hazards model was used to estimate hazard ratios (HRs) for major CVD events (myocardial infarction, stroke, or death) among users of different DPP-4is. The model was adjusted for sex, age, duration of DPP-4i use, use of other glucose-lowering drugs, use of antiplatelet agents, hypertension, dyslipidemia, atrial fibrillation, chronic kidney disease, microvascular complications of diabetes, Charlson comorbidity index, and the calendar index year as potential confounders. RESULTS: Compared to sitagliptin users, the fully adjusted HRs for CVD events were 0.97 (95% confidence interval [CI], 0.94–1.01; p=0.163) for vildagliptin, 0.76 (95% CI, 0.71–0.81; p < 0.001) for saxagliptin, 0.95 (95% CI, 0.92–0.98; p < 0.001) for linagliptin, and 0.84 (95% CI, 0.80–0.88; p < 0.001) for gemigliptin. CONCLUSIONS: Compared to sitagliptin therapy, saxagliptin, linagliptin, and gemigliptin therapies were all associated with a lower risk of cardiovascular events.
