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[Comment] DPP-4 inhibitors and risk of heart failure EXAMINEd

In The Lancet, Faiez Zannad and colleagues1 report on heart failure and mortality outcomes in patients taking alogliptin in a post-hoc analysis of the EXAMINE trial. This report has been eagerly awaited because, in October, 2013, two randomised, placebo-controlled trials, SAVOR TIMI 532 and EXAMINE,3 which assessed blood-glucose lowering with DPP-4 inhibitors, one with saxagliptin and one with alogliptin, reported cardiovascular outcomes. An unexpected 27% increase in hospital admissions for heart failure was shown in SAVOR TIMI 53.