title: Effect of dipeptidyl peptidase-4 inhibitor in patients undergoing bypass surgery.
abstract: OBJECTIVE
  Patients with diabetes mellitus often have more complicated postoperative courses and worse outcomes after coronary artery bypass grafting than those without this condition. Dipeptidyl-peptidase-4 inhibitors are a new class of oral medication for treating type 2 diabetes mellitus. We investigated how these drugs influence the postoperative course after coronary artery bypass in patients with type 2 diabetes mellitus.
  
  
  METHODS
  We retrospectively reviewed the clinical records of 177 patients with type 2 diabetes who has undergone coronary artery bypass surgery between 2009 and 2013; 107 were treated with dipeptidyl-peptidase-4 inhibitors postoperatively, and 70 who did not receive dipeptidyl-peptidase-4 inhibitors served as a control group. The rates of overall survival and major adverse cardiac and cerebrovascular events were compared between groups.
  
  
  RESULTS
  Analysis of all-cause deaths showed that survival at 4 years was 92.8% and 83.6%, respectively, for the treated and control groups (p = 0.052). There was a lower incidence of major adverse cardiac and cerebrovascular events in the treated group (85.6% vs. 73.1%, p = 0.042). Cox regression analysis of the entire population revealed that dipeptidyl-peptidase-4 inhibitor use (hazard ratio 0.46, p = 0.048) and deep sternal wound infection (hazard ratio 11.89, p = 0.003) were independent predictors of major adverse cardiac and cerebrovascular events.
  
  
  CONCLUSIONS
  Dipeptidyl-peptidase-4 inhibitors reduced the incidence of major adverse cardiac and cerebrovascular events and improved the long-term prognosis after coronary artery bypass in patients with type 2 diabetes mellitus.
authors: Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan ogawa@heart-center.or.jp.
authors: Shinji
authors: S
authors: Ogawa
authors: Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan.
authors: Yasuhide
authors: Y
authors: Okawa
authors: Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan.
authors: Koshi
authors: K
authors: Sawada
authors: Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan.
authors: Yoshihiro
authors: Y
authors: Goto
authors: Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan.
authors: Syunsuke
authors: S
authors: Fukaya
authors: Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan.
authors: Takahiko
authors: T
authors: Suzuki
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology / Q000401:mortality; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D018819:Dipeptidyl Peptidase 4 / Q000378:metabolism; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D006331:Heart Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D065840:Protective Factors; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4
keywords: Coronary artery bypass; Diabetes mellitus; Dipeptidyl-peptidase IV inhibitors; Treatment outcome; type 2