We have been waiting for the cardiovascular outcome studies of DPP4 inhibitor, thus treating diabetes closely related with cardiovascular health. The issue of safety of oral hypoglycemic agents on cardiovascular events has important impact on FDA decision and also on physician’s choice for treating each individual with different cardiometabolic risks. In July, 2015, the result of TECOS trial has been published in NEJM: randomized, double-blind clinical trials for sitagliptin add-on therapy in 14, 671 type 2 diabetes to see cardiovascular outcome with composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. I want to discuss about TECOS trials with other CV outcome trials of DPP4 inhibitors in more detail. The unique design of this study has been performed among patients with type 2 diabetes and established cardiovascular disease which means high CV risk.