Dipeptidyl peptidase-IV in chronic heart failure with reduced ejection fraction

• Type: Article in International Scientific Journal
• Date: 2017

Authors

Lourenco, P (Author) FMUP; Silva, S (Author) Other; Cunha, F (Author) Other; Pereira, J (Author) Other; Ribeiro, A (Author) Other; Silva, N (Author) Other; guimaraes, jt (Author) FMUP; Araújo JP (Author) FMUP; Bettencourt P (Author) FMUP

Journal

Title: International Journal of Cardiology

Vol. 241

Pages: 249-254

ISSN: 0167-5273

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 6 Citations

Scopus - 6 Citations

Other information

Authenticus ID: P-00R-AKS

DOI: 10.1016/j.ijcard.2017.03.042

Abstract (EN): Background: An association between dipeptidyl peptidase-IV (DPP-IV) inhibitors with worse prognosis in HF has been suggested. We aimed to assess the serum DPP-IV levels in chronic stable HF patients and determine their association with prognosis. Methods and results: Chronic stable HF patients with optimized prognostic-modifying therapy were prospectively recruited. Exclusion criteria: 1) ejection fraction > 50%, 2) hospitalizations or therapeutic adjustments in the previous 2 months; 3) patients on renal replacement therapy, and 4) use of DPP-IV inhibitors. A fasting venous blood sample was collected and DPP-IV was measured. Patients were followed-up for 3 years and the endpoint studied was all-cause death. Patients' characteristics were compared according to DPP-IV quartiles. A Cox regression analysis was performed and multivariate models were built. The 3rd DPP-IV quartile was the reference category. We studied 264 patients. Mean age: 69 (+/- 13) years, 70.5% were male and 33.7% diabetic. Median (IQR) serum DPP-IV levels were 455.6 (350.0-625.5) ng/mL. DPP-IV had an inverse relationship with age. Patients in 3rd DPP-IV quartile were in lower NYHA classes and had the lowest 3 years all-cause mortality. Patients in the 1st DPP-IV quartile had a multivariate adjusted HR of 3-year mortality of 2.62 (95% CI: 1.15-5.95) when compared with reference category and the HR for the 4th quartile was of 3.79 (95% CI: 1.68-8.54). Conclusions: There is a U-shaped association of serum DPP-IV with mortality in chronic systolic HF patients. Patients in the 3rd DPP-IV quartile have the best multivariate adjusted 3-year survival. DPP-IV inhibition might be harmful in patients with low DPP-IV.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6