Patoulias DI, Boulmpou A, Teperikidis E, Katsimardou A, Siskos F, Doumas M, Papadopoulos CE, Vassilikos V. Cardiovascular efficacy and safety of dipeptidyl peptidase-4 inhibitors: A meta-analysis of cardiovascular outcome trials. World J Cardiol 2021; 13(10): 585-592 [PMID: 34754403 DOI: 10.4330/wjc.v13.i10.585]
Corresponding Author of This Article
Dimitrios Ioannis Patoulias, MD, MSc, Doctor, Research Fellow, Research Scientist, Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Konstantinoupoleos 49 Str., Thessaloniki 54642, Greece. dipatoulias@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Oct 26, 2021; 13(10): 585-592 Published online Oct 26, 2021. doi: 10.4330/wjc.v13.i10.585
Cardiovascular efficacy and safety of dipeptidyl peptidase-4 inhibitors: A meta-analysis of cardiovascular outcome trials
Dimitrios Ioannis Patoulias, Aristi Boulmpou, Eleftherios Teperikidis, Alexandra Katsimardou, Fotios Siskos, Michael Doumas, Christodoulos E Papadopoulos, Vassilios Vassilikos
Dimitrios Ioannis Patoulias, Alexandra Katsimardou, Fotios Siskos, Michael Doumas, Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece
Aristi Boulmpou, Eleftherios Teperikidis, Christodoulos E Papadopoulos, Vassilios Vassilikos, Third Department of Cardiology, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece
Author contributions: Patoulias DI and Doumas M conceived and designed the study; Patoulias DI, Boulmpou A and Teperikidis E collected and analyzed data; Patoulias DI, Boulmpou A and Siskos F performed study quality and risk of bias assessment; Patoulias DI, Boulnpou A, Katsimardou A and Papadopoulos CE wrote the first draft of the study; Doumas M and Vassilikos V critically revised the final draft.
Conflict-of-interest statement: The authors declare no conflict of interest.
PRISMA 2009 Checklist statement: The present meta-analysis was conducted according to 2009 PRISMA Guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitrios Ioannis Patoulias, MD, MSc, Doctor, Research Fellow, Research Scientist, Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Konstantinoupoleos 49 Str., Thessaloniki 54642, Greece. dipatoulias@gmail.com
Received: March 29, 2021 Peer-review started: March 29, 2021 First decision: June 25, 2021 Revised: July 8, 2021 Accepted: September 10, 2021 Article in press: September 10, 2021 Published online: October 26, 2021
ARTICLE HIGHLIGHTS
Research background
Dipeptidyl peptidase-4 (DPP-4) inhibitors are a safe and efficacious treatment option in type 2 diabetes mellitus (T2DM).
Research motivation
Recently, several large, cardiovascular-outcome, randomized controlled trials (RCTs) with DPP-4 inhibitors in patients with T2DM have been published, raising some doubts on the cardiovascular efficacy and safety of this drug class.
Research objectives
Herein the authors provide the most updated and broad relevant meta-analysis by pooling data of interest from the available cardiovascular-outcome RCTs, addressing the cardiovascular efficacy and safety of this drug class.
Research methods
The authors searched PubMed and grey literature sources for all published RCTs assessing cardiovascular outcomes with DPP-4 inhibitors compared to placebo until October 2020.
Research results
Overall, DPP-4 inhibitors seem to have a neutral effect on most surrogate cardiovascular outcome endpoints, such as cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure decompensation, hospitalization for unstable angina or coronary revascularization.
Research conclusions
DPP-4 inhibitors do not provide any clear cardiovascular benefit in patients with T2DM.
Notably, DPP-4 inhibitors are not associated with a significant effect on the risk for major cardiac arrhythmias, except for atrial flutter, increasing the risk by 52% compared to placebo.
Research perspectives
DPP-4 inhibitors do not provide any clear cardiovascular benefit in patients with T2DM.
