title: Association of Sitagliptin with cardiovascular outcome in diabetic patients: a nationwide cohort study.
abstract: OBJECTIVE
  Although dipeptidyl peptidase-4 (DPP-4) inhibitor improves glycemic control, the actual cardiovascular outcomes remain unclear. The objective of this cohort study was to thus evaluate the cardiovascular outcome in diabetic patients who received DPP-4 inhibitors (Sitagliptin).
  
  
  METHODS
  A total of 104,756 new diabetic patients were identified from the Taiwan National Health Insurance Research Database during the period from March 1, 2003 to December 31, 2011. Patients who received Sitagliptin therapy were included as exposures, and up to four age- and sex-matched controls were selected by risk-set sampling. Outcomes such as major adverse cardiovascular diseases (CVD) and deaths were assessed. Logistic regression models were applied to estimate the hazard ratios and 95 % CIs between DPP-4 inhibitor use and cardiovascular outcome.
  
  
  RESULTS
  Over a mean of 14 months, the rates of total CVD per 1000 person-months were significantly lower in Sitagliptin users (3.41 vs. 5.17, p < 0.001), whereas other different CVDs (hazard ratio [HR] 0.59; 95 % confidence interval [CI] 0.48-0.72 for coronary heart disease; HR 0.75; 95 % CI 0.59-0.96 for ischemic stroke; HR 0.86; 95 % CI 0.45-1.65 for peripheral artery occlusive disease) and all-cause mortality (HR 0.56; 95 % CI 0.41-0.74]) were also fewer after adjustment for covariates.
  
  
  CONCLUSIONS
  The results showed a favorable outcome of Sitagliptin as a class on lowering CVD incidence in patients with type 2 diabetes.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Tsung-Yuan
authors.initials: TY
authors.lastname: Yang
authors.affiliation: Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Yung-Po
authors.initials: YP
authors.lastname: Liaw
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Jing-Yang
authors.initials: JY
authors.lastname: Huang
authors.affiliation: School of Medicine, Chung Shan Medical University, Department of Internal Medicine, Chung Shan Medical University Hospital, #110, Section 1, Jian-Guo North Road, Taichung, 402, Taiwan.
authors.forename: Horng-Rong
authors.initials: HR
authors.lastname: Chang
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Kai-Wei
authors.initials: KW
authors.lastname: Chang
authors.affiliation: School of Medicine, Chung Shan Medical University, Department of Internal Medicine, Chung Shan Medical University Hospital, #110, Section 1, Jian-Guo North Road, Taichung, 402, Taiwan. kcueng@gmail.com.
authors.forename: Kwo-Chang
authors.initials: KC
authors.lastname: Ueng
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D058065:Diabetic Cardiomyopathies / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D000068900:Sitagliptin Phosphate / Q000009:adverse effects / Q000627:therapeutic use*; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D000068900:Sitagliptin Phosphate
keywords: Cardiovascular outcome; Diabetes; Mortality; Sitagliptin