Liraglutide for perioperative management of hyperglycaemia in cardiac surgery patients - A multicentre, prospective, randomised superiority trial

Hulst, Abraham H.; Visscher, Maarten J.; Godfried, Marc B.; Thiel, Bram; Gerritse, Bastiaan M.; Scohy, Thierry V.; Bouwman, A.; Willemsen, Mark G. A.; Hollmann, Markus W.; Preckel, B.; DeVries, Hans; Hermanides, Jeroen

doi:10.1053/j.jvca.2019.07.101

Cited by 3 publications

(7 citation statements)

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“…Baseline characteristics were well balanced and are summarised in Table 1. In this trial we observed that patients treated with liraglutide required less insulin for glycaemic control during surgery, compared to placebo, and also had lower glucose concentrations during surgery and ICU admittance [2]. There were no significant differences between the two treatment groups for any of the baseline characteristics.…”

Section: Resultsmentioning

confidence: 73%

“…The sample size was defined by the number of patients included in the intention to treat analysis of the GLOBE trial [2]. Discrete data are presented as count (%) and compared between groups using χ 2 tests or Fisher's exact test.…”

Section: Discussionmentioning

confidence: 99%

“…The study protocol was approved by the medical ethics committee of the Amsterdam UMC (registration number: 2017_012) before initiation of the trial. The detailed study protocol is available open access [12], and the primary results of the GLOBE trial have recently been published [2]. The relevant methodology concerning this cardiac analysis is described below.…”

Section: Methodsmentioning

confidence: 99%

“…Baseline characteristics, comorbidities, perioperative haemodynamic data and glycaemic control were recorded per study protocol as reported previously [2]. Echocardiography was performed as part of routine perioperative care by the treating cardiologist.…”

Section: Data Collection and Outcomesmentioning

confidence: 99%

“…In addition, various cardioprotective mechanisms have been attributed to GLP-1RAs. We recently reported that two preoperative subcutaneous injections of liraglutide (a long-acting GLP-1RA) improved glycaemic control during cardiac surgery (GLOBE trial) [2]. In this secondary analysis of the GLOBE trial, we aimed to evaluate the effect of liraglutide on postoperative cardiac function through analysis of postoperative echocardiography, haemodynamic parameters, and routinely collected biomarkers of cardiac injury.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Liraglutide on Myocardial Function After Cardiac Surgery: A Secondary Analysis of the Randomised Controlled GLOBE Trial

Hulst

Visscher

Cherpanath

et al. 2020

JCM

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Introduction: Previous studies demonstrated the cardioprotective properties of glucagon-like peptide-1 receptor agonists in patients with diabetes or cardiac disease. We investigated whether preoperative subcutaneous liraglutide improves myocardial function after cardiac surgery. Methods: We performed a pre-planned secondary analysis of adult patients undergoing cardiac surgery included in the GLOBE trial. Patients were randomised to receive 0.6 mg subcutaneous liraglutide on the evening before surgery and 1.2 mg after induction of anaesthesia, or matching placebo. Perioperative echocardiographic assessments, haemodynamic parameters, doses of vasoactive inotropic support and postoperative measurements of troponin, Creatine Kinase-MB , creatinine and lactate were compared between groups. Results: The study population consisted of the entire intention-to-treat cohort of the GLOBE trial. In this study, 129 patients received liraglutide and 132 patients placebo. Baseline characteristics were comparable between groups. Postoperatively, 170 (65%) patients underwent echocardiography. In the liraglutide group, more patients had a normal left ventricular systolic function (68%, 59 patients) compared to placebo (53%, 44 patients), difference = 15%, 95%CI = 0-30, p = 0.049. Assessment of the right ventricle revealed no difference in function. Conclusions: Patients receiving short-term preoperative liraglutide treatment better maintained normal myocardial function after cardiac surgery. This study warrants further evaluation of the potential beneficial effects of GLP-1 receptor agonists in cardiac surgery patients.

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Section: Resultsmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Data Collection and Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Liraglutide on Myocardial Function After Cardiac Surgery: A Secondary Analysis of the Randomised Controlled GLOBE Trial

Hulst

Visscher

Cherpanath

et al. 2020

JCM

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Therapie des Diabetes mellitus in der perioperativen Medizin – ein Update

Rupprecht

Stöckl²,

Stöckl

et al. 2020

Anaesthesist

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Umgang mit der Dauermedikation bei Patienten mit Diabetes mellitus

Rupprecht¹,

Stöckl²

2021

Anästhesiol Intensivmed Notfallmed Schmerzther

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ZusammenfassungFür die perioperative Phase besteht bei Patienten mit Diabetes mellitus ein erhöhtes Risiko für Komplikationen, z. B. durch Entgleisung des Glukosestoffwechsels, erhöhte Rate kardiovaskulärer Ereignisse, Verschlechterung einer vorbestehenden Niereninsuffizienz und vermehrt auftretende Wundinfektionen. Zudem können Nebenwirkungen der antidiabetischen Therapie auftreten. Ein spezieller Umgang mit der Dauermedikation bei solchen Patienten ist wichtig.

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Liraglutide for perioperative management of hyperglycaemia in cardiac surgery patients - A multicentre, prospective, randomised superiority trial

Cited by 3 publications

References 0 publications

Effects of Liraglutide on Myocardial Function After Cardiac Surgery: A Secondary Analysis of the Randomised Controlled GLOBE Trial

Effects of Liraglutide on Myocardial Function After Cardiac Surgery: A Secondary Analysis of the Randomised Controlled GLOBE Trial

Therapie des Diabetes mellitus in der perioperativen Medizin – ein Update

Umgang mit der Dauermedikation bei Patienten mit Diabetes mellitus

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