460-P: Treatment with Dipeptidyl Peptidase Inhibitors (DPP-4_Rx) Is Associated with Significant Reduction in Macrovascular Events Independent of Glucose Control

Abstract

We have observed renal protective effects with DPP-4 inhibitor therapy in a prior study done at the VA. Effects of DPP-4_Rx on cardiovascular morbidity and macrovascular events are disputed. Data from a large cohort of veterans diagnosed with type 2 diabetes mellitus (T2DM) were used to identify patients on DPP-4_Rx and without (control). Groups were matched for age (years), sex, BMI, initial renal function, follow-up time (FU, minimum 365 days). Propensity score matching (PSM) was used to adjust groups with a best odds ratio about 1:1. Groups were compared to determine the effect of DPP-4_Rx on the emergence of new macrovascular events identified by ICD-9 and all-cause mortality. Data were extracted using the Veterans Administration Informatics and Computing Infrastructure (VINCI), and analyzed using SAS. Results were compared using t-tests, frequency tables, Kaplan Meier survival curves, hazard ratios (HR) and p values. Results show that subject with DPP-4 (N=24,763) had baseline variables similar to control. DM control improved with DPP-4_Rx but remained worse than control. A significant reduction in new macrovascular events was seen in DPP-4 group (Table). Mortality from all causes was reduced by 78.1%, but time to death was not changed. We conclude that DPP-4_Rx associates with a significant reduction in frequency of all-cause mortality and macrovascular events independent of glucose control. The reduction of macrovascular events explains in part the improved survival and improvements in renal outcomes we have seen before. Disclosure M. Garcia-Touza: None.