Effect of dipeptidyl peptidase-4 inhibitor in patients undergoing bypass surgery

Patients with diabetes mellitus often have more complicated postoperative courses and worse outcomes after coronary artery bypass grafting than those without this condition. Dipeptidyl-peptidase-4 inhibitors are a new class of oral medication for treating type 2 diabetes mellitus. We investigated how these drugs influence the postoperative course after coronary artery bypass in patients with type 2 diabetes mellitus.

We retrospectively reviewed the clinical records of 177 patients with type 2 diabetes who has undergone coronary artery bypass surgery between 2009 and 2013; 107 were treated with dipeptidyl-peptidase-4 inhibitors postoperatively, and 70 who did not receive dipeptidyl-peptidase-4 inhibitors served as a control group. The rates of overall survival and major adverse cardiac and cerebrovascular events were compared between groups.

Analysis of all-cause deaths showed that survival at 4 years was 92.8% and 83.6%, respectively, for the treated and control groups (p = 0.052). There was a lower incidence of major adverse cardiac and cerebrovascular events in the treated group (85.6% vs. 73.1%, p = 0.042). Cox regression analysis of the entire population revealed that dipeptidyl-peptidase-4 inhibitor use (hazard ratio 0.46, p = 0.048) and deep sternal wound infection (hazard ratio 11.89, p = 0.003) were independent predictors of major adverse cardiac and cerebrovascular events.

Dipeptidyl-peptidase-4 inhibitors reduced the incidence of major adverse cardiac and cerebrovascular events and improved the long-term prognosis after coronary artery bypass in patients with type 2 diabetes mellitus.