DPP4 inhibitors (including Linagliptin and Saxagliptin among others) are a class of antidiabetic drugs acting by augmentation of the GLP-1 system. GLP-1 is an incretin hormone released after nutritional and inflammatory stimuli leading to glucose dependent insulin secretion. Although similar glucose lowering efficiacy is reached by different DPP4 inhibitors, only Saxagliptin was found to increase heart failure hospitalization in patients with diabetes. This unexpected effect might relate to the metabolism of Saxagliptin.

We compare the DPP4 inhibitors Linagliptin and Saxagliptin and the Saxagliptin metabolite 5-hydroxy-Saxagliptin during acute myocardial infarction in a murine model of left anterior descending artery ligation.