Comparative cardiovascular risks of dipeptidyl peptidase-4 inhibitors: Analyses of real-world data in Korea

Kyoung Hwa Ha, Bongseong Kim, Hae Sol Shin, Jinhee Lee, Hansol Choi, Hyeon Chang Kim, Dae Jung Kim

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9 Citations (Scopus)


Background and Objectives: To compare cardiovascular disease (CVD) risk associated with 5 different dipeptidyl peptidase-4 inhibitors (DPP-4is) in people with type 2 diabetes. Methods: We identifed 534,327 people who were newly prescribed sitagliptin (n=167,157), vildagliptin (n=67,412), saxagliptin (n=29,479), linagliptin (n=220,672), or gemigliptin (n=49,607) between January 2013 and June 2015 using the claims database of the Korean National Health Insurance System. A Cox proportional hazards model was used to estimate hazard ratios (HRs) for major CVD events (myocardial infarction, stroke, or death) among users of different DPP-4is. The model was adjusted for sex, age, duration of DPP-4i use, use of other glucose-lowering drugs, use of antiplatelet agents, hypertension, dyslipidemia, atrial fbrillation, chronic kidney disease, microvascular complications of diabetes, Charlson comorbidity index, and the calendar index year as potential confounders. Results: Compared to sitagliptin users, the fully adjusted HRs for CVD events were 0.97 (95% confdence interval [CI], 0.94-1.01; p=0.163) for vildagliptin, 0.76 (95% CI, 0.71-0.81; p<0.001) for saxagliptin, 0.95 (95% CI, 0.92-0.98; p<0.001) for linagliptin, and 0.84 (95% CI, 0.80-0.88; p<0.001) for gemigliptin. Conclusions: Compared to sitagliptin therapy, saxagliptin, linagliptin, and gemigliptin therapies were all associated with a lower risk of cardiovascular events.

Original languageEnglish
Pages (from-to)395-405
Number of pages11
JournalKorean Circulation Journal
Issue number5
Publication statusPublished - 2018 May

Bibliographical note

Funding Information:
This research was supported by LG Chem, Ltd. The funder did not play any role in the study design, data collection and analysis, decisions regarding data release, or manuscript preparation.

Funding Information:
This study used National Health Insurance Service (NHIS) data (NHIS-2017-1-059) made by NHIS. This research was supported by a grant of the Korea Health Technology R&D project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI13C0715).

Publisher Copyright:
© 2018 The Korean Society of Cardiology.

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine


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