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Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes: observations from TECOS.

Publication ,  Journal Article
Nauck, MA; McGuire, DK; Pieper, KS; Lokhnygina, Y; Strandberg, TE; Riefflin, A; Delibasi, T; Peterson, ED; White, HD; Scott, R; Holman, RR
Published in: Cardiovasc Diabetol
September 3, 2019

BACKGROUND: To examine the effects of the DPP-4i sitagliptin on CV outcomes during and after incident MI in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). METHODS: TECOS randomized 14,671 participants with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD) to sitagliptin or placebo, in addition to usual care. For those who had a within-trial MI, we analyzed case fatality, and for those with a nonfatal MI, we examined a composite cardiovascular (CV) outcome (CV death or hospitalization for heart failure [hHF]) by treatment group, using Cox proportional hazards models left-censored at the time of the first within-trial MI, without and with adjustment for potential confounders, in intention-to-treat analyses. RESULTS: During TECOS, 616 participants had ≥ 1 MI (sitagliptin group 300, placebo group 316, HR 0.95, 95% CI 0.81-1.11, P = 0.49), of which 25 were fatal [11 and 14, respectively]). Of the 591 patients with a nonfatal MI, 87 (15%) died subsequently, with 66 (11%) being CV deaths, and 57 (10%) experiencing hHF. The composite outcome occurred in 58 (20.1%; 13.9 per 100 person-years) sitagliptin group participants and 50 (16.6%; 11.7 per 100 person-years) placebo group participants (HR 1.21, 95% CI 0.83-1.77, P = 0.32, adjusted HR 1.23, 95% CI 0.83-1.82, P = 0.31). On-treatment sensitivity analyses also showed no significant between-group differences in post-MI outcomes. CONCLUSIONS: In patients with type 2 diabetes and ASCVD experiencing an MI, sitagliptin did not reduce subsequent risk of CV death or hHF, contrary to expectations derived from preclinical animal models. Trial registration clinicaltrials.gov no. NCT00790205.

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Published In

Cardiovasc Diabetol

DOI

EISSN

1475-2840

Publication Date

September 3, 2019

Volume

18

Issue

1

Start / End Page

116

Location

England

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Sitagliptin Phosphate
  • Risk Factors
  • Risk Assessment
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Incidence
  • Humans
 

Citation

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Nauck, M. A., McGuire, D. K., Pieper, K. S., Lokhnygina, Y., Strandberg, T. E., Riefflin, A., … Holman, R. R. (2019). Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes: observations from TECOS. Cardiovasc Diabetol, 18(1), 116. https://doi.org/10.1186/s12933-019-0921-2
Nauck, Michael A., Darren K. McGuire, Karen S. Pieper, Yuliya Lokhnygina, Timo E. Strandberg, Axel Riefflin, Tuncay Delibasi, et al. “Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes: observations from TECOS.Cardiovasc Diabetol 18, no. 1 (September 3, 2019): 116. https://doi.org/10.1186/s12933-019-0921-2.
Nauck MA, McGuire DK, Pieper KS, Lokhnygina Y, Strandberg TE, Riefflin A, et al. Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes: observations from TECOS. Cardiovasc Diabetol. 2019 Sep 3;18(1):116.
Nauck, Michael A., et al. “Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes: observations from TECOS.Cardiovasc Diabetol, vol. 18, no. 1, Sept. 2019, p. 116. Pubmed, doi:10.1186/s12933-019-0921-2.
Nauck MA, McGuire DK, Pieper KS, Lokhnygina Y, Strandberg TE, Riefflin A, Delibasi T, Peterson ED, White HD, Scott R, Holman RR. Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes: observations from TECOS. Cardiovasc Diabetol. 2019 Sep 3;18(1):116.
Journal cover image

Published In

Cardiovasc Diabetol

DOI

EISSN

1475-2840

Publication Date

September 3, 2019

Volume

18

Issue

1

Start / End Page

116

Location

England

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Sitagliptin Phosphate
  • Risk Factors
  • Risk Assessment
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Incidence
  • Humans