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Researchers searched Medline, Embase, Cochrane Central Register of Controlled Trials, (up to June 25, 2015), and communicated with experts to study the association between DPP-4 inhibitors and the risk of heart failure or hospitalization for heart failure in patients with type 2 diabetes. Forty-three trials (n=68,775) and 12 observational studies (n=1,777,358) were considered eligible. Data from the observational studies showed estimates generally similar with trial findings but with very low quality evidence. Overall, the relative effect of DPP-4 inhibitors on heart failure risk in patients with type 2 diabetes is uncertain with the short follow-up and low quality of evidence.

The researchers found that the prevalence of curves of 20 degrees or greater was 1.8 percent. Pooled data of 38 trials reporting heart failure demonstrated low quality evidence for a possible similar risk of heart failure between DPP-4 inhibitor use vs.
Pooled data from the 5 studies reporting admission for heart failure offered moderate quality evidence for an increased risk in patients treated with DPP-4 inhibitors vs.
However, study findings suggest that these drugs may increase risk of hospital admission for heart failure in patients with pre-existing cardiovascular disease or risk factors for vascular diseases vs.

For curves of 20 degrees or greater, the referral rate for radiography was 4.1 percent, sensitivity was 91 percent, and positive predictive value was 40 percent.
A total of 306,144 students who were in fifth grade during five consecutive academic years were screened and followed for 10 years.

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