Unclear impact of vildagliptin treatment in patients with HF and type 2 diabetes
medwireNews: Results of the VIVIDD trial indicate that it is unclear whether treatment with the dipeptidyl peptidase (DPP)-4 inhibitor vildagliptin has a beneficial effect on cardiac outcomes among patients with heart failure (HF) and type 2 diabetes.
John McMurray (University of Glasgow, UK) and fellow researchers found that the 89 patients who were randomly assigned to receive vildagliptin and the 90 participants given placebo experienced comparable changes in left ventricular (LV) ejection fraction from baseline to the 1-year follow-up, with corresponding mean increases of 4.95% and 4.33%.
However, patients in the vildagliptin group had a significantly greater increase in LV end-diastolic volume over the study period than those receiving placebo, with a difference of 17.06 mL, and rates of death and hospitalization were numerically higher among those receiving vildagliptin.
It is not known whether this “unexpected and unexplained increase” in LV volumes “indicates some unexplained action of vildagliptin on left ventricular remodeling or a chance finding”, note the authors.
And they conclude in JACC: Heart Failure: “More evidence is needed regarding the safety of DPP-4 inhibitors in patients with established heart failure and left ventricular systolic dysfunction.”
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