Effect of Liraglutide on Cardiometabolic Risk Profile in People with Coronary Artery Disease with or without Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Whether liraglutide use improves cardiometabolic risk factors in different subsets of subjects with coronary artery disease (CAD) remains unclear. In a systematic review and meta-analysis, we quantified the effects of liraglutide on cardiometabolic risk profile in subjects with CAD with or without type 2 diabetes mellitus (T2D).Methods: Online database searches were conducted in PubMed, Scopus, EMBASE, Web of Science, Cochrane library, and Google Scholar from incept up to 15th January 2021. We identified randomized controlled trials (RCTs) assessing the effects of liraglutide compared to placebo on cardiometabolic risk profile. We used the random- or fixed-effect models to pool the weighted mean differences (WMDs) and 95% confidence intervals (CIs).Results: Out of a total of 7,320 citations, six articles (seven RCTs) with 294 subjects with CAD (mean age, 61.21 years; 19% women) were included. Our findings presented as WMD and 95% CI showed a statistical significant decrease in hemoglobin A1c (HbA1c) [−0.36%; −0.47; −0.26, p < 0.001; I2 = 0.0% (with 6 RCTs)], body mass index (BMI) [−0.61 kg/m2; −1.21; −0.01, p = 0.047; I2 = 72.2% (with five RCTs)], and waist circumference [−2.41 cm; −3.47; −1.36, p < 0.001; I2 = 0.0% (with three RCTs)]. Through a set of subgroup analyses, we found a significant reduction in BMI in CAD patients with T2D [WMD = −1.06; 95% CI, −1.42, −0.70, p < 0.001; I2 = 0.0% (with three RCTs)] compared to CAD only patients [WMD = −0.08; 95% CI, −0.45, 0.29, p = 0.66; I2 = 0.0% (with two RCTs)] in the liraglutide group compared with the placebo group. No significant changes in heart rate, blood pressure, and lipid profiles were observed.Conclusions: Among people with established CAD, liraglutide significantly improved HbA1c, BMI, and waist circumference values. The effect of liraglutide on BMI was more robust in individuals with T2D compared to those without.

Liraglutide does not increase heart rate of diabetic patients during acute myocardial infarction

“…Rondinelli et al found that the use of liraglutide in diabetic patients did not increase the patients' HR. 10,20 However, most of the patients in that study did not have related heart diseases. However, Tougaard et al found that liraglutide increased the HR about 8-9 bpm in patients with systolic heart failure (average left ventricular ejection fraction [LVEF] 34%-35%).…”

Effect of liraglutide on cardiac function in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials

“…[ 40 ] Another meta-analysis indicated that liraglutide significantly improved cardiometabolic risk profile in patients with or without type 2 diabetes coronary artery disease. [ 41 ] In trials assessing cardiovascular outcomes, GLP-1 receptor agonist treatment reduced the risk of death from cardiovascular causes and fatal or nonfatal stroke in patients with type 2 diabetes compared to placebo, as revealed by a meta-analysis conducted by Qin et al [ 42 ] Currently, there is still controversy regarding the dosage of Liraglutide. Since the included RCTs in this meta-analysis recommended a dosage of 1.8mg, it was not possible to conduct comparative analysis between different dosages.…”

Dysfunctional High-Density Lipoproteins in Type 2 Diabetes Mellitus: Molecular Mechanisms and Therapeutic Implications

“…Concerning the effects on CV risk factors, including lipids, a recent meta-analysis evaluated the effect of liraglutide on cardiometabolic factors in individuals with or without T2DM. Whereas a marked effect was seen on BMI among T2DM patients, no changes were observed on plasma HDL-C levels [ 157 ]. This result is in line with a previous meta-analysis, in which no effect by liraglutide on HDL-C was observed [ 158 ], and with the results of others GLP-1 agonists [ 159 , 160 ].…”