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Chronic obstructive pulmonary disease (COPD) is recognized as a systemic inflammatory ailment frequently accompanied by diabetes mellitus (DM) and cardiovascular disease, substantially raising the chances of major adverse cardiovascular events (MACE).
Dipeptidyl peptidase-4 inhibitor use is associated with a lower risk of major adverse cardiovascular events in individuals with chronic obstructive pulmonary disease and comorbid diabetes mellitus.
Chronic obstructive pulmonary disease (COPD) is recognized as a systemic inflammatory ailment frequently accompanied by diabetes mellitus (DM) and cardiovascular disease, substantially raising the chances of major adverse cardiovascular events (MACE).
Dipeptidyl peptidase-4 inhibitors (DPP-4i), commonly prescribed for type 2 DM are reported to possess anti-inflammatory and potential cardiovascular protective properties beyond glucose lowering. This nationwide retrospective cohort study explored the link between DPP-4i use and the risk of MACE in COPD and comorbid DM.
Researchers analyzed data from Taiwan's National Health Insurance Research Database collected between 2016 and 2021. Subjects aged ≥40 years who had at least one hospitalization for COPD and a diagnosis of DM were enrolled. DPP-4i users were identified through prescription records via Anatomical Therapeutic Chemical (ATC) code A10BH*, while non-users received other antidiabetic medications without DPP-4i therapy.
The key outcome was major adverse cardiovascular events (MACE), defined as a composite of stroke, cardiovascular death, and myocardial infarction. Cox proportional hazards models were utilized to estimate adjusted hazard ratios (HRs) with 95% confidence intervals after adjusting for demographic characteristics, comorbidities, and overall ailment burden.
The study encompassed 24,215 subjects with COPD and DM, comprising 5,737 (23.7%) DPP-4i users and 18,478 (76.3%) non-users. During follow-up, DPP-4i users experienced a markedly lower incidence of MACE than non-users (Table 1).
Compared with DPP-4i users, non-users had a greater risk of MACE (adjusted HR, 1.56). The association remained consistent across both sexes, different age groups, and patients with a history of myocardial infarction, stroke, or hypertensio
DPP-4 inhibitor use was linked with a reduced risk of MACE in COPD and diabetes, suggesting cardiovascular benefits beyond glycemic control. However, further randomized controlled trials were warranted to establish causality.
International Journal of Chronic Obstructive Pulmonary Disease
Dipeptidyl Peptidase-4 Inhibitor Use and Risk of Major Adverse Cardiovascular Events in Patients with COPD and Diabetes: A Nationwide Retrospective Cohort Study
Chung-Han Ho et al.
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