Effect of dipeptidyl peptidase-4 inhibitor on all-cause mortality and coronary revascularization in diabetic patients
- Authors
- Park H.E.[Park H.E.]; Jeon J.[Jeon J.]; Hwang I.-C.[Hwang I.-C.]; Sung J.[Sung J.]; Lee S.-P.[Lee S.-P.]; Kim H.-K.[Kim H.-K.]; Cho G.-Y.[Cho G.-Y.]; Sohn D.-W.[Sohn D.-W.]; Kim Y.-J.[Kim Y.-J.]
- Issue Date
- Dec-2015
- Publisher
- 한국심초음파학회
- Keywords
- Cardiovascular outcome; Computed tomography; Dipeptidyl peptidase-4 inhibitor; Mortality
- Citation
- Journal of Cardiovascular Ultrasound, v.23, no.4, pp.233 - 243
- Indexed
- SCOPUS
KCI
- Journal Title
- Journal of Cardiovascular Ultrasound
- Volume
- 23
- Number
- 4
- Start Page
- 233
- End Page
- 243
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/42095
- DOI
- 10.4250/jcu.2015.23.4.233
- ISSN
- 1975-4612
- Abstract
- Background: Anti-atherosclerotic effect of dipeptidyl peptidase-4 (DPP-4) inhibitors has been suggested from previous studies, and yet, its association with cardiovascular outcome has not been demonstrated. We aimed to evaluate the effect of DPP-4 inhibitors in reducing mortality and coronary revascularization, in association with baseline coronary computed tomography (CT). Methods: The current study was performed as a multi-center, retrospective observational cohort study. All subjects with diabetes mellitus who had diagnostic CT during 2007–2011 were included, and 1866 DPP-4 inhibitor users and 5179 non-users were compared for outcome. The primary outcome was all-cause mortality and secondary outcome included any coronary revascularization therapy after 90 days of CT in addition to all-cause mortality. Results: DPP-4 inhibitors users had significantly less adverse events [0.8% vs. 4.4% in users vs. non-users, adjusted hazard ratios (HR) 0.220, 95% confidence interval (CI) 0.102–0.474, p = 0.0001 for primary outcome, 4.1% vs. 7.6% in users vs. non-users, HR 0.517, 95% CI 0.363–0.735, p = 0.0002 for secondary outcome, adjusted variables were age, sex, presence of hypertension, high sensitivity C-reactive protein, glycated hemoglobin, statin use, coronary artery calcium score and degree of stenosis]. Interestingly, DPP-4 inhibitor seemed to be beneficial only in subjects without significant stenosis (adjusted HR 0.148, p = 0.0013 and adjusted HR 0.525, p = 0.0081 for primary and secondary outcome). Conclusion: DPP-4 inhibitor is associated with reduced all-cause mortality and coronary revascularization in diabetic patients. Such beneficial effect was significant only in those without significant coronary stenosis, which implies that DPP-4 inhibitor may have beneficial effect in earlier stage of atherosclerosis. © 2015 Korean Society of Echocardiography.
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