Dapagliflozin Shows Added Cardiac Benefits Over Linagliptin in T2DM with Heart Failure: Study
A new study published in the journal of Medicine showed that both linagliptin and dapagliflozin have good safety profiles and successfully enhance cardiac function and glycemic management in individuals with type 2 diabetes mellitus (T2DM) and heart failure (HF).
Heart failure is a particularly serious consequence that is 2-4 times more common in people with T2DM and substantially worsens prognosis, quality of life, and healthcare burden. Agents with both glycemic and cardiovascular advantages have been presented in recent therapeutic developments. Through metabolic and hemodynamic effects, sodium-glucose cotransporter 2 inhibitors, such as dapagliflozin, enhance glycemic management while lowering cardiovascular mortality and HF hospitalization.
Dipeptidyl peptidase-4 inhibitors, such as linagliptin, provide modest cardiovascular protection and increase insulin secretion with a minimal risk of hypoglycemia. To provide practical evidence to support clinical decision-making, this study retrospectively assesses and contrasts the clinical effects of dapagliflozin and linagliptin on cardiac function and glycemic control in patients with T2DM complicated by HF.
200 patients with both T2DM and HF were involved in this retrospective analysis. They were split into two groups according to their treatment plans: a control group and a treatment group (100 patients each). Every patient was given metformin along with normal anti-HF medication. For 6 months, the treatment group was given dapagliflozin (10 mg once daily) while the control group was given linagliptin (5 mg once daily before breakfast). For both groups, pertinent clinical data was gathered and examined. The two groups' baseline characteristics were similar (P >.05).
Dapagliflozin considerably improved clinical symptoms, as evidenced by the treatment group's higher overall effective rate (97.5% vs. 80.0%, P<.001). With no statistically significant differences between groups (P >.05), both groups demonstrated substantial decreases in fasting blood glucose, 2-hour postprandial blood glucose, and HbA1c compared with baseline values (P <.001), indicating that both medications successfully enhance glycemic control.
Compared to the control group, the treatment group showed higher improvements in NT-proBNP, fibroblast growth factor 23, central pulse pressure, left ventricular ejection fraction, left ventricular end-diastolic diameter, and left ventricular remodeling index (P<.05), which suggests a more significant impact of dapagliflozin on cardiac function. Adverse medication responses were rare and did not differ substantially across the groups (2.0% in the control group versus 4.0% in the treatment group, P >.05).
Overall, both linagliptin and dapagliflozin have favorable safety profiles and can successfully decrease blood glucose levels and enhance cardiac function in individuals with T2DM and HF. Further research is required to confirm the potential benefits of dapagliflozin in enhancing heart function.
Source:
Zai, W., Dai, T., Wang, L., & Liu, B. (2025). Comparative analysis of dapagliflozin and linagliptin in managing type 2 diabetes mellitus and heart failure: A retrospective study. Medicine, 104(50), e44709. https://doi.org/10.1097/MD.0000000000044709
