NPPA and ischemia: Research has shown that treatment with DPP4 inhibiters before cardiac ischemia-reperfusion (I/R) injuries leads to improved survival rates and better heart function in rats, which is partly due to the activation of the phospho-Ak mouse strain thymoma (pAkt), phospho-glycogen synthase kinase 3 (pGSK3), and atrial natriuretic peptide (ANP) pathways8.