{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T16:58:18Z","timestamp":1765817898047,"version":"3.48.0"},"reference-count":27,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,4,27]]},"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The SAVOR TIMI\u201353 study reported a significant increase in the risk of hospitalisation for heart failure (HF) in patients treated with a DPP-4 inhibitor (DPP-4i) in comparison with placebo. A recent case-control study in part confirmed this risk signal. Our aim was to compare the occurrence of HF in relation to DPP-4i use versus any antidiabetic treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based matched case-control study conducted using administrative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The Italian Region of Piedmont (4.4 million inhabitants).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>From a database of 282\u2005000 patients treated with antidiabetic drugs, we identified 14\u2005613 hospitalisations for HF, 7212 incident cases, and 1727 hospital re-admissions between 2008 and 2012; each case was matched for gender, age and antidiabetic therapy with 10 controls; cases and controls were compared for exposure to DPP-4i.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>ORs and 95% CIs were calculated by fitting a conditional logistic model. All analyses were adjusted for available risk factors for HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found no increased risk of hospitalisation for HF associated with the use of DPP-4i (OR for admission for HF 1.00 (0.94 to 1.07), incident HF1.01 (0.92 to 1.11), recurrent HF 1.02 (0.84 to 1.22)). All-cause mortality was 6% lower in DPP-4i users (p&lt;0.001), whereas insulin users showed an excess of risk for any type of hospital admission (19%) and death (20%) (p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that, in an unselected population of diabetic patients, the use of DPP-4i is not associated with an increased risk of HF. The favourable impact on all-cause mortality should be viewed with caution and also other explanations investigated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-007959","type":"journal-article","created":{"date-parts":[[2015,6,5]],"date-time":"2015-06-05T21:35:19Z","timestamp":1433540119000},"page":"e007959","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Hospitalisation for heart failure and mortality associated with dipeptidyl peptidase 4 (DPP-4) inhibitor use in an unselected population of subjects with type 2 diabetes: a nested case\u2013control study"],"prefix":"10.1136","volume":"5","author":[{"given":"Carlo B","family":"Giorda","sequence":"first","affiliation":[{"name":"Metabolism and Diabetes Unit, ASL TO5, Regione Piemonte, Chieri, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Picariello","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, ASL TO3, Regione Piemonte, Grugliasco, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Tartaglino","sequence":"additional","affiliation":[{"name":"Chaira Medica Association, Chieri, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Marafetti","sequence":"additional","affiliation":[{"name":"Metabolism and Diabetes Unit, ASL TO5, Regione Piemonte, Chieri, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabiana","family":"Di Noi","sequence":"additional","affiliation":[{"name":"Metabolism and Diabetes Unit, ASL TO5, Regione Piemonte, Chieri, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Alessiato","sequence":"additional","affiliation":[{"name":"Metabolism and Diabetes Unit, ASL TO5, Regione Piemonte, Chieri, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Costa","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, ASL TO3, Regione Piemonte, Grugliasco, Italy"},{"name":"Department of Clinical and Biological Sciences, University of Torino, Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Gnavi","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, ASL TO3, Regione Piemonte, Grugliasco, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,6,5]]},"reference":[{"key":"2025121508540429000_5.6.e007959.1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12175"},{"key":"2025121508540429000_5.6.e007959.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1307684"},{"key":"2025121508540429000_5.6.e007959.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.010389"},{"key":"2025121508540429000_5.6.e007959.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.012883"},{"key":"2025121508540429000_5.6.e007959.5","unstructured":"Scirica BM , Raz I , Cavender MA , et al , on behalf of the SAVOR-TIMI 53 Steering Committee and Investigators. 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