{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T09:13:43Z","timestamp":1774516423330,"version":"3.50.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,6,5]]},"abstract":"\n Background<\/jats:title>\n \n Antihyperglycemic therapies may increase the risk of cardiovascular events including hospitalization for heart failure. There is a paucity of data evaluating the cardiovascular safety of antihyperglycemic therapies in the high\u2010risk period following an acute coronary syndrome (\n ACS<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n The\n EXAMINE<\/jats:styled-content>\n (Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care) trial randomized 5380 patients who were 15 to 90\u00a0days post\n ACS<\/jats:styled-content>\n to the dipeptidyl dipeptidase\u2010IV (\n DPP<\/jats:styled-content>\n \u2010\n IV<\/jats:styled-content>\n ) inhibitor alogliptin versus placebo; mean follow\u2010up was 18\u00a0months. Using a landmark analysis, we assessed the (1) burden of cardiovascular events from randomization to 6\u00a0months (early period) and from 6\u00a0months to the end of follow\u2010up (late period) and (2) the risk of cardiovascular events associated with early (up to 6\u00a0months) and chronic (6\u00a0months to end of follow\u2010up)\n DPP<\/jats:styled-content>\n \u2010\n IV<\/jats:styled-content>\n inhibition with alogliptin. Patients with early versus late events had similar baseline demographic profiles. Overall, 42.1% of the composite of cardiovascular death\/myocardial infarction\/stroke and 47.5% of hospitalization for heart failure occurred in the early period. Early\n DPP<\/jats:styled-content>\n \u2010\n IV<\/jats:styled-content>\n inhibition did not increase the risk of early cardiovascular death\/myocardial infarction\/stroke (hazard ratio 0.96, 95% confidence interval, 0.76\u20131.21) or hospitalization for heart failure (1.23, 95% confidence interval, 0.84\u20131.82). Similarly, chronic\n DPP<\/jats:styled-content>\n \u2010\n IV<\/jats:styled-content>\n inhibition did not increase the risk of late cardiovascular death\/myocardial infarction\/stroke (hazard ratio 1.03, 95% confidence interval, 0.89\u20131.26) or hospitalization for heart failure (hazard ratio 1.02, 95% confidence interval, 0.85\u20131.22).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Early after an\n ACS<\/jats:styled-content>\n , patients with type 2 diabetes mellitus experience a significant burden of\n HF<\/jats:styled-content>\n events and recurrent\n ACS<\/jats:styled-content>\n .\n DPP<\/jats:styled-content>\n \u2010\n IV<\/jats:styled-content>\n inhibition with alogliptin appears to be safe even in the high\u2010risk period following an\n ACS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.007649","type":"journal-article","created":{"date-parts":[[2018,5,16]],"date-time":"2018-05-16T09:15:16Z","timestamp":1526462116000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Early and Chronic Dipeptidyl\u2010Peptidase\u2010IV Inhibition and Cardiovascular Events in Patients With Type 2 Diabetes Mellitus After an Acute Coronary Syndrome: A Landmark Analysis of the EXAMINE Trial"],"prefix":"10.1161","volume":"7","author":[{"given":"Abhinav","family":"Sharma","sequence":"first","affiliation":[{"name":"INSERM CIC 1433 Universit\u00e9 de Lorraine and CHRU, Nancy, France"},{"name":"Duke Clinical Research Institute, Duke University, Durham, NC"},{"name":"Division of Cardiology, Stanford University, Palo Alto, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Baim Institute for Clinical Research, Brigham and Women's Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William B.","family":"White","sequence":"additional","affiliation":[{"name":"University of Connecticut School of Medicine, Farmington, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuyin","family":"Liu","sequence":"additional","affiliation":[{"name":"Baim Institute for Clinical Research, Brigham and Women's Hospital and Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George L.","family":"Bakris","sequence":"additional","affiliation":[{"name":"University of Chicago Pritzker School of Medicine, Chicago, IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C.","family":"Cushman","sequence":"additional","affiliation":[{"name":"Memphis Veterans Affairs Medical Center, University of Tennessee College of Medicine, Memphis, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"INSERM CIC 1433 Universit\u00e9 de Lorraine and CHRU, Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-S011"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-014-3460-0"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw039"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2014.08.004"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.179"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu505"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.01.021"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv320"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70031-2"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.010389"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw106"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1305889"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.08.004"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)00049-8"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.071589"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62070-X"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.05.005"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv728"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw110"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509225"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.10260"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504720"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611925"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62225-X"},{"key":"e_1_3_4_27_2","unstructured":"FDA Drug Safety Communication: FDA adds warnings about heart failure risk to labels of type 2 diabetes medicines containing saxagliptin and alogliptin. 2014. Available at: https:\/\/www.fda.gov\/Drugs\/DrugSafety\/ucm486096.htm. Accessed July 22 2017."},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.0103"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1501352"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1307684"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-050214-013431"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410489"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.117.007649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:57:40Z","timestamp":1715597860000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.117.007649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,5]]},"references-count":31,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,6,5]]}},"alternative-id":["10.1161\/JAHA.117.007649"],"URL":"https:\/\/doi.org\/10.1161\/jaha.117.007649","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,5]]},"assertion":[{"value":"2017-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e007649"}}