Cardiovascular outcomes in patients who experienced a myocardial infarction while treated with liraglutide versus placebo in the LEADER trial

Michael A. Nauck, Karen Tornøe, Søren Rasmussen, Marianne Bach Treppendahl, Steven P. Marso

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalDiabetes and Vascular Disease Research
DOIs
StateAccepted/In press - Jun 1 2018

Fingerprint

Myocardial Infarction
Placebos
Hospitalization
Heart Failure
Confidence Intervals
Liraglutide
Standard of Care
Random Allocation
Type 2 Diabetes Mellitus
Necrosis
Ischemia

Keywords

  • cardiovascular death
  • cardiovascular outcomes
  • Glucagon-like peptide-1 receptor agonists
  • heart failure
  • myocardial infarction

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

Cite this

Cardiovascular outcomes in patients who experienced a myocardial infarction while treated with liraglutide versus placebo in the LEADER trial. / Nauck, Michael A.; Tornøe, Karen; Rasmussen, Søren; Treppendahl, Marianne Bach; Marso, Steven P.

In: Diabetes and Vascular Disease Research, 01.06.2018.

Research output: Contribution to journalArticle

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abstract = "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.",
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