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The TECOS trial demonstrated cardiovascular safety (non-inferiority to placebo) for sitagliptin, but it did not show a statistically significant reduction in MACE

Furthermore, PKM2 activation contributes to the intracellular accumulation of succinate, a signaling metabolite that stabilizes HIF-1 and promotes interleukin-1 beta (IL-1) production during inflammatory responses (Tannahill et al., 2013)