详细
Background. Dipeptidyl peptidase-4 (DPP-4) inhibitors are generally an effective and safe class of antidiabetic drugs for the treatment of type 2 diabetes mellitus (DM2). To date, a series of large randomized controlled trials (RCTs) has been conducted on the cardiovascular safety of the use of DPP-4 inhibitors. Objective. Evaluation of the effect of DPP-4 inhibitors on the risk of cardiovascular events in subgroups of patients with different renal function, as well as among patients who received drugs of this class in addition to metformin. Methods. RCTs were searched in the National Institutes of Health PubMed database for key words as of 12/09/2021. Outcomes assessed included the MACE composite endpoint, death from cardiovascular causes, non-fatal acute myocardial infarction, and non-fatal stroke. Results. In DM2 patients with a high risk of MACE and preserved kidney function, therapy with DPP-4 inhibitor (alogliptin) was associated with a reduced risk ratio for the development of tripartite (RR=0.81; 95% CI: 0.65-0.99) and quadruple (RR=0, 82; 95% CI: 0.650.99) MACE and death from cardiovascular causes (RR=0.61; 95% CI: 0.41-0.92). The addition of alogliptin to metformin compared with metformin alone resulted in a reduced risk of MACE, as well as death from cardiovascular causes and death from all causes. In most studies, DPP-4 inhibitors did not affect the risks of cardiovascular outcomes. Conclusion. DPP-4 inhibitors did not increase the risk of developing cardiovascular events in DM2 patients, and some representatives may have a potential protective effect on the risks of developing certain cardiovascular events in patients with normal kidney function or early stages of chronic kidney disease (glomerular filtration rate> 60 ml/min/1.73 m2) and normoalbuminuria, as well as when used in combination with metformin.
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