title: Sitagliptin and risk of heart failure hospitalization in patients with type 2 diabetes on dialysis: A population-based cohort study.
abstract: The incidence of heart failure hospitalization (HHF) after taking sitagliptin in type 2 diabetes (T2DM) patients with end stage renal disease (ESRD) on dialysis is unclear. In this population-based cohort study, we identified individuals with T2DM and ESRD on dialysis who were treated with sitagliptin between 2009 and 2011 and randomly selected a control cohort matched by age, sex, duration of T2DM, hypertension medications, use of statin and aspirin, sulfonylureas, glinides, and insulin usage, atherosclerotic heart disease, congestive heart failure and chronic obstructive pulmonary disease at a 1:4 ratio. Multivariable Cox proportional hazards regression analysis was used to evaluate HHF risk. The overall incidence of HHF was higher in the sitagliptin cohort than in the control cohort (1130 vs. 754 per 10000 person-years; adjusted hazard ratio (HR): 1.52, 95% CI = 1.21-1.90). There was a significant trend towards increased HHF risk associated with increased sitagliptin dose (p for trend < 0.01). Subjects at greater risk of HHF after taking sitagliptin were those without severe hypoglycemia, without ACE inhibitors treatment, with history of heart failure or receiving hemodialysis rather than peritoneal dialysis. In conclusion, use of sitagliptin was associated with an increased risk of HHF in patients with T2DM on dialysis.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan.|Department of Medicine, China Medical University, Taichung 40402, Taiwan.
authors.forename: Yi-Chih
authors.initials: YC
authors.lastname: Hung
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan.|Department of Public Health, China Medical University, Taichung 40402, Taiwan.
authors.forename: Che-Chen
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan.|Department of Medicine, China Medical University, Taichung 40402, Taiwan.
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Huang
authors.affiliation: Department of Nursing, School of Health, National Taichung University of Science and Technology, Taichung 40343, Taiwan.
authors.forename: Man-Ping
authors.initials: MP
authors.lastname: Chang
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan.|School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006333:Heart Failure / Q000139:chemically induced* / Q000150:complications* / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010919:Placebos; D006435:Renal Dialysis; D012307:Risk Factors; D000068900:Sitagliptin Phosphate / Q000009:adverse effects*
chemical_list: D010919:Placebos; D000068900:Sitagliptin Phosphate