While studies on the use of novel antidiabetic agents in the setting of cardiac surgeries are limited at the moment, our review of the current literature suggests that all three agents (GLP-1RAs, DPP-4 inhibitors, and SGLT2is) are safe for use in the perioperative period, with SLGT2i showing the most benefits in HF management and other organ protection for those with or without DM undergoing cardiac surgery. This evidence concerns the gene DPP4 and hydrops fetalis.