Protecting the Diabetic Heart: Insights into the Cardiovascular Impact of DPP-4 Inhibitors

Abstract

Diabetes poses a significant risk for cardiovascular disease. Clinical evidence, however, suggests that strict glycemic control does not decrease cardiovascular mortality, but rather increases it. This is partly because the majority of oral anti-diabetic medications have negative cardiovascular effects. For the treatment of type 2 diabetes, dipeptidyl peptidase-4 inhibitors are available as oral antidiabetic medications. This review focuses on the cardiovascular effects of DPP4 inhibitors. We utilised PubMed search engine, google Scholar to find relevant studies. DPP4 inhibitors, a new kind of oral anti-diabetic drug, have undergone several large-scale clinical studies to assess its cardiovascular safety. Incretin-based oral glucose-lowering medications known as dipeptidyl peptidase-4 inhibitors have been shown to be effective and safe for treating type 2 diabetes mellitus. Their metabolic impact is achieved by protecting incretin hormones such as glucagon-like peptide-1 from the breakdown of DPP-4. Several clinical studies are being conducted to assess the cardiovascular safety of DPP4 inhibitors. Three major prospective DPP4 inhibitor studies with cardiovascular outcomes were reported. Suggests Saxagliptin assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus (SAVOR-TIMI 53) and comprehensive patient-level pooled analysis with lingliptin versus standard comparator in patients with type 2 diabetes and CVD found that DPP4 inhibitors, such as saxagliptin and lingliptin, did not increase the risk of CV events in patients with type 2 diabetes and established CVD. DPP-4 inhibitors have been shown to lower numerous cardiovascular risk factors. Type-2 diabetes patients who are treated with DPP-4 inhibitors may experience cardiovascular benefits. But the risk of heart failure hospitalization remains a contentious issue, necessitating further multi-centre trials to establish the safety of DPP-4 inhibitors.