The efficacy and safety of DPP-4 inhibitors considering cardiovascular risk factors

Abstract

In most diabetic patients, cardiovascular diseases, especially myocardial infarction and cerebral stroke, remain the main cause of death. Thus, the control of risk factors, especially glycemic control, plays a key role in death prevention. Additional (other than hypoglycemic) effects of antidiabetic agents remain an open question. Currently available agents include the recently introduced class of DPP-4 inhibitors. Numerous clinical trials confirmed their efficacy in reducing glycemia and safety of use. There are reasons to argue that, in addition to hypoglycemic effect, inhibition of GLP-1 degradation may contribute to reducing the risk of cardiovascular complications. This paper is an overview of the present state of knowledge of the effect of GLP-1 and inhibition of its degradation on cardiovascular risk. The final settlement of this question will take place after publication of the results of large clinical trials assessing the effect ofDPP-4 inhibitors on the development of cardiovascular outcomes.