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Notably, most patients enrolled in trials with neutral HF outcomes have concomitant prescriptions for RAAS inhibitors, which could ameliorate the tendency of DPP-4 inhibitors to worsen HF.58,59 Combination therapy may counteract the detrimental effects of DPP-4 inhibitors, thus masking the harmful effects

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However, long-term clinical studies (Phase 4) have not confirmed a heightened risk of bleeding after ghutathione

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