title: Associations of dipeptidyl peptidase-4 inhibitors with mortality in hospitalized heart failure patients with diabetes mellitus.
abstract: BACKGROUND
  Heart failure (HF) and diabetes mellitus (DM) often co-exist. Treatment of DM in HF patients is challenging because some therapies for DM are contraindicated in HF. Although previous experimental studies have reported that dipeptidyl peptidase-4 (DPP-4) inhibitors improve cardiovascular function, whether DPP-4 inhibition improves mortality of HF patients with DM remains unclear. Therefore, we examined the impact of DPP-4 inhibition on mortality in hospitalized HF patients using propensity score analyses.
  
  
  RESULTS
  We performed observational study analysed by propensity score method with 962 hospitalized HF patients. Of these patients, 293 (30.5%) had DM, and 122 of these DM patients were treated with DPP-4 inhibitors. Propensity scores for treatment with DPP-4 inhibitors were estimated for each patient by logistic regression with clinically relevant baseline variables. The propensity-matched 1:1 cohorts were assessed based on propensity scores (DPP-4 inhibitors,n= 83, and non-DPP-4 inhibitors,n= 83). Kaplan-Meier analysis in the propensity score-matched cohort demonstrated that cardiac and all-cause mortality was significantly lower in the DPP-4 inhibitor group than in the non-DPP-4 inhibitor group (cardiac mortality: 4.8% vs. 18.1%,P= 0.015; all-cause mortality: 14.5% vs. 41.0%,P= 0.003, by a log-rank test). In the multivariable Cox proportional hazard analyses, after adjusting for other potential confounding factors, the use of DPP-4 inhibitors was an independent predictor of all-cause mortality (pre-matched cohort: hazard ratio 0.467,P= 0.010; post-matched cohort: hazard ratio 0.370,P= 0.003) in HF patients with DM.
  
  
  CONCLUSIONS
  Our data suggest that DPP-4 inhibitors may improve cardiac and all-cause mortality in hospitalized HF patients with DM.
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Akihiko
authors: A
authors: Sato
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Akiomi
authors: A
authors: Yoshihisa
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Yuki
authors: Y
authors: Kanno
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Mai
authors: M
authors: Takiguchi
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Shunsuke
authors: S
authors: Miura
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Takeshi
authors: T
authors: Shimizu
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Yuichi
authors: Y
authors: Nakamura
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Hiroyuki
authors: H
authors: Yamauchi
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Takashi
authors: T
authors: Owada
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Takamasa
authors: T
authors: Sato
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Satoshi
authors: S
authors: Suzuki
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Masayoshi
authors: M
authors: Oikawa
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Takayoshi
authors: T
authors: Yamaki
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Koichi
authors: K
authors: Sugimoto
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Hiroyuki
authors: H
authors: Kunii
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Kazuhiko
authors: K
authors: Nakazato
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Hitoshi
authors: H
authors: Suzuki
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Shu-Ichi
authors: SI
authors: Saitoh
authors: Department of Cardiology and Hematology Fukushima Medical University Fukushima Japan.
authors: Yasuchika
authors: Y
authors: Takeishi
keywords: Diabetes mellitus; Dipeptidyl‐peptidase‐4 inhibitors; Heart failure; Prognosis; Propensity score analyses