TY - JOUR
T1 - Cardiovascular outcomes in patients who experienced a myocardial infarction while treated with liraglutide versus placebo in the LEADER trial
AU - Nauck, Michael A.
AU - Tornøe, Karen
AU - Rasmussen, Søren
AU - Treppendahl, Marianne Bach
AU - Marso, Steven P.
N1 - Funding Information:
Editorial support was provided by Gillian Groeger, PhD, and Izabel James, MBBS, of Watermeadow Medical, an Ashfield company, part of UDG Healthcare PLC, funded by Novo Nordisk.
Publisher Copyright:
© The Author(s) 2018.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Objective: Animal studies demonstrated that glucagon-like peptide-1 receptor agonists reduce myocardial necrosis following regional ischaemia induction. This effect may improve cardiovascular outcomes after myocardial infarction. Risk of cardiovascular death or hospitalisation for heart failure after myocardial infarction was evaluated in patients with type 2 diabetes at high cardiovascular risk in the LEADER trial. Methods: Data from patients randomised to liraglutide or placebo, in addition to standard of care, in Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) (NCT01179048) were analysed post hoc. Cox regression, with myocardial infarction as a time-dependent covariate, was used to analyse time from randomisation to a composite of cardiovascular death or hospitalisation for heart failure. Results: Patients who experienced myocardial infarction had a sevenfold higher risk of the composite endpoint (with myocardial infarction: n = 148, 25.0%; without myocardial infarction: n = 716, 8.2%; hazard ratio: 7.0; 95% confidence interval: 5.8, 8.4). The risk of the composite endpoint after myocardial infarction was not significantly lower in the liraglutide group (n = 63, 23.0%) compared with placebo (n = 85, 26.7%; hazard ratio: 0.91; 95% confidence interval: 0.66, 1.26). Conclusion: The data demonstrated that having myocardial infarction significantly increased the risk of subsequent cardiovascular death or hospitalisation for heart failure. However, we did not find evidence for a reduced risk in these cardiovascular outcomes following myocardial infarction in patients treated with liraglutide versus placebo.
AB - Objective: Animal studies demonstrated that glucagon-like peptide-1 receptor agonists reduce myocardial necrosis following regional ischaemia induction. This effect may improve cardiovascular outcomes after myocardial infarction. Risk of cardiovascular death or hospitalisation for heart failure after myocardial infarction was evaluated in patients with type 2 diabetes at high cardiovascular risk in the LEADER trial. Methods: Data from patients randomised to liraglutide or placebo, in addition to standard of care, in Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) (NCT01179048) were analysed post hoc. Cox regression, with myocardial infarction as a time-dependent covariate, was used to analyse time from randomisation to a composite of cardiovascular death or hospitalisation for heart failure. Results: Patients who experienced myocardial infarction had a sevenfold higher risk of the composite endpoint (with myocardial infarction: n = 148, 25.0%; without myocardial infarction: n = 716, 8.2%; hazard ratio: 7.0; 95% confidence interval: 5.8, 8.4). The risk of the composite endpoint after myocardial infarction was not significantly lower in the liraglutide group (n = 63, 23.0%) compared with placebo (n = 85, 26.7%; hazard ratio: 0.91; 95% confidence interval: 0.66, 1.26). Conclusion: The data demonstrated that having myocardial infarction significantly increased the risk of subsequent cardiovascular death or hospitalisation for heart failure. However, we did not find evidence for a reduced risk in these cardiovascular outcomes following myocardial infarction in patients treated with liraglutide versus placebo.
KW - Glucagon-like peptide-1 receptor agonists
KW - cardiovascular death
KW - cardiovascular outcomes
KW - heart failure
KW - myocardial infarction
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U2 - 10.1177/1479164118783935
DO - 10.1177/1479164118783935
M3 - Article
C2 - 29947247
AN - SCOPUS:85049697547
SN - 1479-1641
VL - 15
SP - 465
EP - 468
JO - Diabetes and Vascular Disease Research
JF - Diabetes and Vascular Disease Research
IS - 5
ER -