Research

Hormonal

DPP-4 inhibitors (specifically Saxagliptin and Alogliptin) may increase the risk of hospitalization for heart failure, whereas Sitagliptin and Linagliptin appear neutral.

If you have Type 2 Diabetes and Heart Failure, be cautious with DPP-4 inhibitors. Saxagliptin and Alogliptin have been linked to an increased risk of heart failure hospitalization. However, Sitagliptin and Linagliptin have shown neutral effects. Discuss the specific risks and benefits with your doctor to choose the safest option for your heart.

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RCTs suggest that dipeptidyl peptidase-4 inhibitors, including saxagliptin and possibly alogliptin, may increase the risk of hospitalized HF, probably owing to increased circulating vasoactive peptides, which impair endothelial function, activate sympathetic tones, and cause cardiac remodeling.
Chih‐Neng Hsu et al. · Life · 2023

Why this rating

Based on RCTs (SAVOR-TIMI 53, EXAMINE) showing increased risk for Saxagliptin/Alogliptin, but neutral for Sitagliptin/Linagliptin.

Source

Anti-Diabetic Therapy and Heart Failure: Recent Advances in Clinical Evidence and Molecular Mechanism

Chih‐Neng Hsu et al. · Life · 2023

DOI 10.3390/life13041024

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DOI resolved against Crossref · corpus check 2026-06-10

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