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A Multicenter Observational Study of Incretin-based Drugs and Heart Failure
Abstract
Background There is concern that antidiabetic incretin-based drugs, including dipeptidyl peptidase 4 (DPP-4) inhibitors and glucagon-like peptide 1 (GLP-1) analogues, can increase the risk of heart failure. Ongoing clinical trials may not have large enough samples to effectively address this issue. Methods We applied a common protocol in the analysis of multiple cohorts of patients with diabetes. We used health care data from four Canadian provinces, the United States, and the United Kingdom. With the use of a nested case-control analysis, we matched each patient who was hospitalized for heart failure with up to 20 controls from the same cohort; matching was based on sex, age, cohort-entry date, duration of treated diabetes, and follow-up time. Cohort-specific hazard ratios for hospitalization due to heart failure among patients receiving incretin-based drugs, as compared with those receiving oral antidiabetic-drug combinations, were estimated by means of conditional logistic regression and pooled across cohorts with the use of random-effects models. Results The cohorts included a total of 1,499,650 patients, with 29,741 hospitalized for heart failure (incidence rate, 9.2 events per 1000 persons per year). The rate of hospitalization for heart failure did not increase with the use of incretin-based drugs as compared with oral antidiabetic-drug combinations among patients with a history of heart failure (hazard ratio, 0.86; 95% confidence interval [CI], 0.62 to 1.19) or among…
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Saxagliptin has raised concerns regarding potential increased risks of heart failure.
“This contrasts with saxagliptin, another dipeptidyl peptidase-4 inhibitor, which has raised concerns regarding potential increased risks of heart failure, and linagliptin, which is commonly prescribed for patients with kidney impairment, and thus could lead to increased confounding in contrast to our comparator sitagliptin.20-25”
From Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction (2025) · cites this paper as [22]
Linagliptin is commonly prescribed for patients with kidney impairment, which could lead to increased confounding in contrast to sitagliptin.
“This contrasts with saxagliptin, another dipeptidyl peptidase-4 inhibitor, which has raised concerns regarding potential increased risks of heart failure, and linagliptin, which is commonly prescribed for patients with kidney impairment, and thus could lead to increased confounding in contrast to our comparator sitagliptin.20-25”
From Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction (2025) · cites this paper as [22]
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The Cardiovascular Biology of Glucagon-like Peptide-1
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Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction
Krüger, N., Schneeweiss, S., Fuse, K., Matseyko, S., Sreedhara, S. K., Hahn, G., Schunkert, H., & Wang, S. V. (2025) · JAMA · doi:10.1001/jama.2025.14092 · Cited by 66
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Metadata
- Authors
- Filion, K. B., Azoulay, L., Platt, R. W., Dahl, M., Dormuth, C. R., Clemens, K. K., Hu, N., Paterson, J. M., Targownik, L., Turin, T. C., Udell, J. A., & Ernst, P.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2016-03-24
- Volume
- 374
- Issue
- 12
- Pages
- 1145-1154
- ISSN
- 0028-4793
- 1533-4406
- Cited by
- 196
- References
- 4
- Language
- en
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