Effects of liraglutide, a glucagon-like peptide-1 analog, on left ventricular remodeling assessed by cardiac magnetic resonance imaging in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Abstract

The clinical efficacy of glucagon-like peptide-1 (GLP-1) analogs in patients with acute myocardial infarction (AMI) is uncertain. The purpose of the present study was to evaluate the effects of the GLP-1 analog liraglutide on left ventricular (LV) remodeling in patients with AMI. We retrospectively evaluated the effects of liraglutide on LV remodeling assessed by cardiac magnetic resonance imaging (CMRI) in 15 patients with type 2 diabetes who were successfully treated with primary percutaneous coronary intervention (PCI) for AMI. Patients were divided into two groups based on their hypoglycemic medication: liraglutide use (group L; n = 6) or standard therapy (group S; n = 9). The CMRI findings in the early phase and at the 6-month follow-up were compared. At the 6-month follow-up, group S showed increases in LV end-diastolic (from 64 to 74 mL/m(2), p = 0.08) and end-systolic (from 38 to 45 mL/m(2), p = 0.13) volume indexes, whereas no such increase was observed in group L. The LV mass index (LVMI) was significantly smaller in group L than in group S at baseline (64 vs. 75 g/m(2), p = 0.05) and at follow-up (56 vs. 78 g/m(2), p = 0.009). Multivariate regression analysis showed that liraglutide use was an independent negative predictor of LVMI (β = -0.720, p = 0.003). In conclusion, liraglutide may be able to prevent the progression of LV remodeling and is associated with a lower LV mass in diabetic patients with AMI undergoing primary PCI.

Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Cardiac Disorders

“…Other relevant articles were found by using the references from the identified articles. It was found that 18 trials [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] explored the use of GLP in MI and HF.…”

“…Out of the 18 trials, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] 11 trials [4][5][6][7][8][9][10][11][12][13][14] evaluated the effects of GLP-1 RAs on MI. The MI trials [4][5][6][7][8][9][10][11][12][13][14] are summarized in Table 1, and all 11 showed a significant benefit of GLP-1 RAs.…”

“…Nozue et al 11 conducted a retrospective, single-center pilot study that included 15 patients with type 2 diabetes who received successful primary PCI treatment for acute MI within 24 hours of symptom onset. Patients were divided into 2 groups based on whether they were treated with liraglutide or other standard diabetes medication(s).…”

“…Studies have been conducted to determine if GLP-1 RAs may be useful in the treatment of cardiac disorders, such as heart failure (HF) and myocardial infarction (MI). [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Two main theories about the mechanism of action of GLP-1 RAs in HF have been proposed. The first one is that GLP-1 RAs may improve cardiac function by increasing glucose uptake, cyclic adenosine monophosphate release, and cyclic guanosine monophosphate release, which lead to vasodilation and can improve coronary flow and left ventricular (LV) pressure.…”

Cardiovascular Effects of Glucagon-Like Peptide-1 Receptor Agonists

“…With subcutaneous liraglutide treatment, Chen et al [ 96 ] observed a mild improvement in LV ejection fraction in ST-segment elevation MI patients who were not necessarily diabetic. On the other hand, in a retrospective study with acute MI patients who were diabetic, Nozue et al [ 97 ] observed that liraglutide use was an independent negative predictor of LV mass index, suggesting liraglutide might prevent the progression of post-MI LV remodeling. Taken together, the results of numerous small studies equivocally suggest that GLP-1 RA treatment in coronary artery disease patients would be beneficial, regardless of the presence of diabetes.…”