The TECOS trial is a multicenter, randomized, double-blind study that sought to study the cardiovascular (CV) safety of sitagliptin in patients with type 2 diabetes mellitus (DM2). It enrolled 14,671 patients with DM2 and established CV disease with glycated hemoglobin level 6.5-8.0% on a stable dose of 1-2 antihyperglycemic agents or on insulin therapy and randomized them to receive either sitagliptin or placebo. The primary outcome of cardiovascular death, MI, stroke, or hospitalization for unstable angina was similar in both groups, P<0.001 for noninferiority. Unlike rosiglitazone that increased the incidence of heart failure, sitagliptin was noted to be safe in terms of the incidence of new heart failure. The authors of the TECOS trial concluded that among patients with type 2 diabetes and established CV disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events.