In a study of hospital admissions in the EXAMINE trial, treatment with the dipeptidyl peptidase 4 (DDP-4) inhibitor alogliptin did not increase the risk of heart failure in patients with type 2 diabetes mellitus and a recent acute coronary syndrome event. During follow-up (median 533 days), rates of major adverse cardiac events were similar in patients who received alogliptin and those who received placebo (16.0% vs 16.5%; HR 0.98, 95% CI 0.86–1.12), and hospital admissions for heart failure were also not different between the two groups (3.1% vs 2.9%; HR 1.07, 95% CI 0.79–1.46). Despite concerns over increased rates of heart failure observed with another DDP-4 inhibitor in a previous trial, heart failure outcomes were not changed by alogliptin in the present study.