Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes : observations from TECOS

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Nauck , M A , McGuire , D K , Pieper , K S , Lokhnygina , Y , Strandberg , T E , Riefflin , A , Delibasi , T , Peterson , E D , White , H D , Scott , R & Holman , R R 2019 , ' Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes : observations from TECOS ' , Cardiovascular Diabetology , vol. 18 , no. 1 , 116 . https://doi.org/10.1186/s12933-019-0921-2

Title: Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes : observations from TECOS
Author: Nauck, Michael A.; McGuire, Darren K.; Pieper, Karen S.; Lokhnygina, Yuliya; Strandberg, Timo E.; Riefflin, Axel; Delibasi, Tuncay; Peterson, Eric D.; White, Harvey D.; Scott, Russell; Holman, Rury R.
Contributor: University of Helsinki, HUS Internal Medicine and Rehabilitation
Date: 2019-09-03
Language: eng
Number of pages: 10
Belongs to series: Cardiovascular Diabetology
ISSN: 1475-2840
URI: http://hdl.handle.net/10138/305593
Abstract: Background To examine the effects of the DPP-4i sitagliptin on CV outcomes during and after incident MI in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). Methods TECOS randomized 14,671 participants with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD) to sitagliptin or placebo, in addition to usual care. For those who had a within-trial MI, we analyzed case fatality, and for those with a nonfatal MI, we examined a composite cardiovascular (CV) outcome (CV death or hospitalization for heart failure [hHF]) by treatment group, using Cox proportional hazards models left-censored at the time of the first within-trial MI, without and with adjustment for potential confounders, in intention-to-treat analyses. Results During TECOS, 616 participants had >= 1 MI (sitagliptin group 300, placebo group 316, HR 0.95, 95% CI 0.81-1.11, P = 0.49), of which 25 were fatal [11 and 14, respectively]). Of the 591 patients with a nonfatal MI, 87 (15%) died subsequently, with 66 (11%) being CV deaths, and 57 (10%) experiencing hHF. The composite outcome occurred in 58 (20.1%; 13.9 per 100 person-years) sitagliptin group participants and 50 (16.6%; 11.7 per 100 person-years) placebo group participants (HR 1.21, 95% CI 0.83-1.77, P = 0.32, adjusted HR 1.23, 95% CI 0.83-1.82, P = 0.31). On-treatment sensitivity analyses also showed no significant between-group differences in post-MI outcomes. Conclusions In patients with type 2 diabetes and ASCVD experiencing an MI, sitagliptin did not reduce subsequent risk of CV death or hHF, contrary to expectations derived from preclinical animal models. Trial registration clinicaltrials.gov no. NCT00790205
Subject: Acute myocardial infarction
Cardiovascular outcomes
Sitagliptin
Type 2 diabetes
GLUCAGON-LIKE PEPTIDE-1
RECEPTOR AGONISTS
CARDIAC-FUNCTION
OUTCOMES
SIZE
REPERFUSION
ISCHEMIA
MELLITUS
IMPROVES
LIRAGLUTIDE
3121 General medicine, internal medicine and other clinical medicine
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