Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Comparative Cardiovascular Risks of Dipeptidyl Peptidase-4 Inhibitors: Analyses of Real-world Data in Korea

  • Ha, Kyoung Hwa (Department of Endocrinology and Metabolism, Ajou University School of Medicine) ;
  • Kim, Bongseong (Department of Statistics and Actuarial Science, Soongsil University) ;
  • Shin, Hae Sol (Department of Biostatistics, Yonsei University College of Medicine) ;
  • Lee, Jinhee (Department of Endocrinology and Metabolism, Ajou University School of Medicine) ;
  • Choi, Hansol (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kim, Hyeon Chang (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kim, Dae Jung (Department of Endocrinology and Metabolism, Ajou University School of Medicine)
  • Received : 2017.10.25
  • Accepted : 2018.01.25
  • Published : 2018.05.31
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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.

Keywords

Acknowledgement

Supported by : Korea Health Industry Development Institute (KHIDI), LG Chem, Ltd.

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