- 著者
 
          - 
             
             Masayoshi Yamamoto
             
             Yoshihiro Seo
             
             Tomoko Ishizu
             
             Isao Nishi
             
             Yoshie Hamada-Harimura
             
             Tomoko Machino-Ohtsuka
             
             Kimi Sato
             
             Seika Sai
             
             Akinori Sugano
             
             Kenichi Obara
             
             Kazutaka Aonuma
             
          
 
          
          
          - 出版者
 
          - 日本循環器学会
 
          
          
          - 雑誌
 
          - Circulation Journal (ISSN:13469843)
 
          
          
          - 巻号頁・発行日
 
          - vol.81, no.11, pp.1662-1669, 2017-10-25 (Released:2017-10-25)
 
          
          
          - 参考文献数
 
          - 27
 
          
          
          - 被引用文献数
 
          - 
             
             
             9
             
             
          
        
 
        
        
        Background:Although experimental animal studies report many pleiotropic effects of dipeptidyl peptidase-4 inhibitors (DPP-4i), their prognostic value has not been demonstrated in clinical trials.Methods and Results:Among 838 prospectively enrolled heart failure (HF) patients hospitalized for acute decompensated HF, 79 treated with DPP-4i were compared with 79 propensity score-matched non-DPP-4i diabetes mellitus (DM) patients. The primary endpoint was all-cause mortality; the secondary endpoint was a composite of cardiovascular death and hospitalization. During follow-up (423±260 days), 8 patients (10.1%) in the DPP-4i group and 13 (16.5%) in the non-DPP-4i group died (log-rank, P=0.283). The DPP-4i group did not have a significantly higher rate of all-cause mortality (log-rank, P=0.283), or cardiovascular death or hospitalization (log-rank, P=0.425). In a subgroup analysis of HF with preserved ejection fraction (HFpEF; n=75), the DPP-4i group had a significantly better prognosis than the non-DPP-4i group regarding the primary endpoint (log-rank, P=0.021) and a tendency to have better prognosis regarding the secondary endpoint (log-rank, P=0.119). In patients with HF with reduced EF (n=83), DPP-4i did not result in better prognosis.Conclusions:DPP-4i did not increase the risk of adverse clinical outcomes in patients with DM and HF. DPP-4i may be beneficial in HFpEF.