However, the Canadian Network for Observational Drug Effect Studies (CNODES) retrospectively analyzed administrative electronic health records of nearly 1.5 million patients and concluded that DPP-4 inhibitors did not increase the rate of heart failure hospitalization compared with oral anti-diabetic drug combinations among patients with (13.8 vs 11.6%, HR 0.87, 95% CI, 0.63–1.21) or without a history of heart failure (9.6 vs 8.9%, HR 0.84, 95% CI 0.69–1.02) [69]. Here, DPP4 is linked to heart failure.