title: Risk of new-onset heart failure in patients using sitagliptin: a population-based cohort study.
abstract: OBJECTIVE
  To examine whether patients using sitagliptin at the time of an acute coronary syndrome event are at increased risk of incident heart failure compared with those not exposed.
  
  
  METHODS
  Using US claims data, people with diabetes without a history of heart failure in the 3 years before hospitalization for acute coronary syndrome were identified for the period 2004 to 2010. We used a nested case-control design, whereby cases were patients who developed incident heart failure <30 days after admission to hospital for acute coronary syndrome and were matched by age and sex with up to 10 controls with no heart failure. Subjects exposed or not exposed to sitagliptin in the 90 days before acute coronary syndrome admission were compared using conditional logistic regression after adjustment for clinical and laboratory data, healthcare utilization and propensity scores.
  
  
  RESULTS
  In total, 457 cases of heart failure developing de novo after diagnosis of acute coronary syndrome were matched to 4570 controls. The average age of the subjects was 55 years and 65% were male. Overall, 11 of 147 (7%) people exposed to sitagliptin developed heart failure compared with 446 of the 4880 people not exposed (9%, adjusted odds ratio 0.75, 95% CI 0.38-1.46; P=0.40). Sitagliptin exposure before acute coronary syndrome was not associated with an increased risk of death or heart failure combined (7% vs 9%, adjusted odds ratio 0.66, 95% CI 0.34-1.28).
  
  
  CONCLUSIONS
  In our sample of patients who are at high risk of heart failure after acute coronary syndrome, sitagliptin exposure was not associated with an increased risk of de novo heart failure.
authors.affiliation: School of Public Health, University of Alberta, Edmonton, Alberta, Canada.|ACHORD, 2-040 Li Ka Shing Center, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: D T
authors.initials: DT
authors.lastname: Eurich
authors.affiliation: Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.|Clinical and Health Informatics Research Group, Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
authors.forename: D L
authors.initials: DL
authors.lastname: Weir
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: S H
authors.initials: SH
authors.lastname: Simpson
authors.affiliation: School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Senthilselvan
authors.affiliation: Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: F A
authors.initials: FA
authors.lastname: McAlister
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000628:therapy; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D058065:Diabetic Cardiomyopathies / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D057216:Propensity Score; D012306:Risk; D000068900:Sitagliptin Phosphate / Q000009:adverse effects* / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D000068900:Sitagliptin Phosphate