Liraglutide May Affect Clinical Outcomes of Myocardial Infarction in Type 2 Diabetes
Liraglutide may reduce the incidence of myocardial infarction in patients who have a high cardiovascular risk with type 2 diabetes.
A study recently published in The American Journal of Cardiology has shown that liraglutide may affect clinical outcomes of myocardial infarction (MI), and that it is effective in reducing the occurrence of MI in individuals with type 2 diabetes who are also at risk for adverse cardiovascular events.
This post-hoc analysis characterized subtypes of MI in the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial. This trial included 9340 patients with type 2 diabetes who were at significant risk for cardiovascular events, of whom 4668 were given liraglutide and 4672 were assigned to the a placebo group. The study researchers characterized the MIs in LEADER according to their occurrence, subtype, outcome, treatment arm, and troponin levels. Type 2 diabetes is well-known to increase the risk for MI by a 2-fold. However, this study aimed to contribute data on the differences in MI subtypes between subjects treated with liraglutide vs those in a placebo group.
In the group treated with liraglutide, there were 359 MIs vs 421 in the placebo group (P =.022). The liraglutide group also included 17 fatal MIs vs 28 in the placebo group (P =.28). In both treatment arms, spontaneous MI (518/641) and non–ST-segment elevation MI (555/641) were the main symptomatic MIs. These symptomatic MIs were more common when troponin levels were ≤5× or ≤10× the upper reference limit with liraglutide (P =.16) vs placebo (P =.42). More liraglutide-treated patients had a history of coronary artery bypass graft (P =.008) vs those in the placebo group. Fewer liraglutide-treated patients presented with more than 50% arterial stenosis (P =.044) or peripheral arterial disease in lower extremities (P =.005).
Researchers conclude that “liraglutide reduces the total number of MI events in patients with type 2 [diabetes] at high risk, but no significant differences in subtype distribution were found between treatment groups. However, numeric differences in some subtypes between treatment groups suggest that liraglutide may also impact the clinical outcomes of MI.”
Marso SP, Nauck MA, Monk Fries T, Rasmussen S, Treppendahl MB, Buse JB; the LEADER Publication Committee on behalf of the LEADER Trial Investigators. Myocardial infarction subtypes in patients with type 2 diabetes mellitus and the effect of liraglutide therapy (from the LEADER trial) [published online March 15, 2018]. Am J Cardiol. doi: 10.1016/j.amjcard.2018.02.030