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However, DPP-4 inhibitors have not reduced the risk of major adverse cardiovascular events, possibly because potentiation of SDF-1 enhances plaque growth and instability, activates deleterious neurohormonal mechanisms, and promotes cardiac inflammation and fibrosis

Originally developed and positioned as treatments for type 2 diabetes, these agents are now equally associated with weight management, reshaping how clinicians, patients, and pharmacies understand metabolic disease

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