DPP4 and heart failure: A previous clinical trial demonstrated that patients treated with saxagliptin have a unexpected higher incidence of hospitalization for heart failure, this increased risk of heart failure hospitalization was not associated with an increased risk of cardiovascular death or all-cause mortality, the potential explanation is associate with hemodilution.[22] On the other hand, a recent meta-analysis showed that treatment with DPP-4 inhibitors did not significantly increase cardiovascular outcomes in these patients with type 2 diabetes.[23]