Skip to main content
Erschienen in: Herz 5/2020

22.11.2018 | Review articles

Efficacy of liraglutide intervention in myocardial infarction

A meta-analysis of randomized controlled trials

verfasst von: X. Yang, Z. Liang

Erschienen in: Herz | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Abstract

Introduction

The efficacy of liraglutide intervention for myocardial infarction (MI) remains controversial. We conducted a systematic review and meta-analysis to explore the influence of liraglutide intervention versus placebo on cardiac function for MI.

Methods

We searched PubMed, Embase, Web of science, EBSCO, and Cochrane library databases through April 2018 for randomized controlled trials (RCTs) assessing the effect of liraglutide intervention versus placebo on MI. This meta-analysis was performed using the random-effect model.

Results

Four randomized controlled trials involving 469 patients were included in the meta-analysis. Overall, compared with control group for MI, liraglutide intervention significantly improved left ventricular ejection fraction (mean difference [MD] = 4.42; 95% confidence interval [CI] =1.71 to 7.14; P = 0.001), superoxide dismutase (MD = 6.89; 95% CI = 1.80 to 11.98; P = 0.008), and decreased high-sensitivity C‑reactive protein (MD = −0.21; 95% CI = −0.33 to −0.09; P = 0.0006), but had no remarkable influence on major adverse cardiovascular events (risk ratio = 0.56; 95% CI = 0.28–1.09; P = 0.09), recurrence of MI (risk ratio = 0.50; 95% CI = 0.19–1.30; P = 0.16), repeated revascularization (risk ratio = 0.49; 95% CI = 0.17–1.42; P = 0.19), and cardiac death (risk ratio = 0.57; 95% CI = 0.12–2.73; P = 0.48).

Conclusions

Liraglutide intervention is associated with significantly improved left ventricular ejection fraction and superoxide dismutase, reduced high-sensitivity C‑reactive protein in patients with MI, but has no remarkable impact on major adverse cardiovascular events, recurrence of MI, repeated revascularization or cardiac death.
Literatur
1.
Zurück zum Zitat Keeley EC, Boura JA, Grines CL (2003) Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 361:13–20CrossRef Keeley EC, Boura JA, Grines CL (2003) Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 361:13–20CrossRef
3.
Zurück zum Zitat Russo JJ, Bagai A, Le May MR, Yan AT (2018) Immediate non-culprit vessel percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and cardiogenic shock: a swinging pendulum. J Thorac Dis 10:661–666CrossRef Russo JJ, Bagai A, Le May MR, Yan AT (2018) Immediate non-culprit vessel percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and cardiogenic shock: a swinging pendulum. J Thorac Dis 10:661–666CrossRef
7.
Zurück zum Zitat Cao B, Zhang C, Wang H, Xia M, Yang X (2018) Renoprotective effect of remote ischemic postconditioning in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Ther Clin Risk Manag 14:369–375CrossRef Cao B, Zhang C, Wang H, Xia M, Yang X (2018) Renoprotective effect of remote ischemic postconditioning in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Ther Clin Risk Manag 14:369–375CrossRef
8.
Zurück zum Zitat Gersh BJ, Stone GW, White HD, Holmes DR Jr. (2005) Pharmacological facilitation of primary percutaneous coronary intervention for acute myocardial infarction: is the slope of the curve the shape of the future? JAMA 293:979–986CrossRef Gersh BJ, Stone GW, White HD, Holmes DR Jr. (2005) Pharmacological facilitation of primary percutaneous coronary intervention for acute myocardial infarction: is the slope of the curve the shape of the future? JAMA 293:979–986CrossRef
9.
Zurück zum Zitat Ceriello A, Novials A, Ortega E, Canivell S, La Sala L, Pujadas G et al (2013) Glucagon-like peptide 1 reduces endothelial dysfunction, inflammation, and oxidative stress induced by both hyperglycemia and hypoglycemia in type 1 diabetes. Diabetes Care 36:2346–2350CrossRef Ceriello A, Novials A, Ortega E, Canivell S, La Sala L, Pujadas G et al (2013) Glucagon-like peptide 1 reduces endothelial dysfunction, inflammation, and oxidative stress induced by both hyperglycemia and hypoglycemia in type 1 diabetes. Diabetes Care 36:2346–2350CrossRef
10.
Zurück zum Zitat Noyan-Ashraf MH, Momen MA, Ban K, Sadi AM, Zhou YQ, Riazi AM et al (2009) GLP-1R agonist liraglutide activates cytoprotective pathways and improves outcomes after experimental myocardial infarction in mice. Diabetes 58:975–983CrossRef Noyan-Ashraf MH, Momen MA, Ban K, Sadi AM, Zhou YQ, Riazi AM et al (2009) GLP-1R agonist liraglutide activates cytoprotective pathways and improves outcomes after experimental myocardial infarction in mice. Diabetes 58:975–983CrossRef
11.
Zurück zum Zitat Chen WR, Hu SY, Chen YD, Zhang Y, Qian G, Wang J et al (2015) Effects of liraglutide on left ventricular function in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am Heart J 170:845–854CrossRef Chen WR, Hu SY, Chen YD, Zhang Y, Qian G, Wang J et al (2015) Effects of liraglutide on left ventricular function in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am Heart J 170:845–854CrossRef
12.
Zurück zum Zitat Chen WR, Chen YD, Tian F, Yang N, Cheng LQ, Hu SY et al (2016) Effects of Liraglutide on reperfusion injury in patients with ST-segment-elevation myocardial infarction. Circ Cardiovasc Imaging 9:e5146CrossRef Chen WR, Chen YD, Tian F, Yang N, Cheng LQ, Hu SY et al (2016) Effects of Liraglutide on reperfusion injury in patients with ST-segment-elevation myocardial infarction. Circ Cardiovasc Imaging 9:e5146CrossRef
13.
Zurück zum Zitat Chen WR, Tian F, Chen YD, Wang J, Yang JJ, Wang ZF et al (2016) Effects of liraglutide on no-reflow in patients with acute ST-segment elevation myocardial infarction. Int J Cardiol 208:109–114CrossRef Chen WR, Tian F, Chen YD, Wang J, Yang JJ, Wang ZF et al (2016) Effects of liraglutide on no-reflow in patients with acute ST-segment elevation myocardial infarction. Int J Cardiol 208:109–114CrossRef
14.
Zurück zum Zitat Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62:1006–1012CrossRef Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62:1006–1012CrossRef
15.
Zurück zum Zitat Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ et al (1996) Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials 17:1–12CrossRef Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ et al (1996) Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials 17:1–12CrossRef
16.
Zurück zum Zitat Kjaergard LL, Villumsen J, Gluud C (2001) Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 135:982–989CrossRef Kjaergard LL, Villumsen J, Gluud C (2001) Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 135:982–989CrossRef
17.
Zurück zum Zitat Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558CrossRef Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558CrossRef
18.
Zurück zum Zitat Chen WR, Shen XQ, Zhang Y, Chen YD, Hu SY, Qian G et al (2016) Effects of liraglutide on left ventricular function in patients with non-ST-segment elevation myocardial infarction. Endocrine 52:516–526CrossRef Chen WR, Shen XQ, Zhang Y, Chen YD, Hu SY, Qian G et al (2016) Effects of liraglutide on left ventricular function in patients with non-ST-segment elevation myocardial infarction. Endocrine 52:516–526CrossRef
19.
Zurück zum Zitat Undas A, Wiek I, Stepien E, Zmudka K, Tracz W (2008) Hyperglycemia is associated with enhanced thrombin formation, platelet activation, and fibrin clot resistance to lysis in patients with acute coronary syndrome. Diabetes Care 31:1590–1595CrossRef Undas A, Wiek I, Stepien E, Zmudka K, Tracz W (2008) Hyperglycemia is associated with enhanced thrombin formation, platelet activation, and fibrin clot resistance to lysis in patients with acute coronary syndrome. Diabetes Care 31:1590–1595CrossRef
20.
Zurück zum Zitat Kosiborod M (2018) Hyperglycemia in acute coronary syndromes: from mechanisms to prognostic implications. Endocrinol Metab Clin North Am 47:185–202CrossRef Kosiborod M (2018) Hyperglycemia in acute coronary syndromes: from mechanisms to prognostic implications. Endocrinol Metab Clin North Am 47:185–202CrossRef
21.
Zurück zum Zitat Lee TF, Burt MG, Heilbronn LK, Mangoni AA, Wong VW, McLean M et al (2017) Relative hyperglycemia is associated with complications following an acute myocardial infarction: a post-hoc analysis of HI-5 data. Cardiovasc Diabetol 16:157CrossRef Lee TF, Burt MG, Heilbronn LK, Mangoni AA, Wong VW, McLean M et al (2017) Relative hyperglycemia is associated with complications following an acute myocardial infarction: a post-hoc analysis of HI-5 data. Cardiovasc Diabetol 16:157CrossRef
22.
Zurück zum Zitat Park JY, Takahara N, Gabriele A, Chou E, Naruse K, Suzuma K et al (2000) Induction of endothelin-1 expression by glucose: an effect of protein kinase C activation. Diabetes 49:1239–1248CrossRef Park JY, Takahara N, Gabriele A, Chou E, Naruse K, Suzuma K et al (2000) Induction of endothelin-1 expression by glucose: an effect of protein kinase C activation. Diabetes 49:1239–1248CrossRef
23.
Zurück zum Zitat Marenzi G, Cosentino N, Milazzo V, De Metrio M, Cecere M, Mosca S et al (2018) Prognostic value of the acute-to-chronic glycemic ratio at admission in acute myocardial infarction: a prospective study. Diabetes Care 41:847–853CrossRef Marenzi G, Cosentino N, Milazzo V, De Metrio M, Cecere M, Mosca S et al (2018) Prognostic value of the acute-to-chronic glycemic ratio at admission in acute myocardial infarction: a prospective study. Diabetes Care 41:847–853CrossRef
24.
Zurück zum Zitat Muller O, Trana C, Eeckhout E (2013) Myocardial no-reflow treatment. Curr Vasc Pharmacol 11:278–285PubMed Muller O, Trana C, Eeckhout E (2013) Myocardial no-reflow treatment. Curr Vasc Pharmacol 11:278–285PubMed
25.
Zurück zum Zitat Zhao T, Parikh P, Bhashyam S, Bolukoglu H, Poornima I, Shen YT et al (2006) Direct effects of glucagon-like peptide-1 on myocardial contractility and glucose uptake in normal and postischemic isolated rat hearts. J Pharmacol Exp Ther 317:1106–1113CrossRef Zhao T, Parikh P, Bhashyam S, Bolukoglu H, Poornima I, Shen YT et al (2006) Direct effects of glucagon-like peptide-1 on myocardial contractility and glucose uptake in normal and postischemic isolated rat hearts. J Pharmacol Exp Ther 317:1106–1113CrossRef
26.
Zurück zum Zitat Bekkers SC, Yazdani SK, Virmani R, Waltenberger J (2010) Microvascular obstruction: underlying pathophysiology and clinical diagnosis. J Am Coll Cardiol 55:1649–1660CrossRef Bekkers SC, Yazdani SK, Virmani R, Waltenberger J (2010) Microvascular obstruction: underlying pathophysiology and clinical diagnosis. J Am Coll Cardiol 55:1649–1660CrossRef
27.
Zurück zum Zitat Jaffe R, Charron T, Puley G, Dick A, Strauss BH (2008) Microvascular obstruction and the no-reflow phenomenon after percutaneous coronary intervention. Circulation 117:3152–3156CrossRef Jaffe R, Charron T, Puley G, Dick A, Strauss BH (2008) Microvascular obstruction and the no-reflow phenomenon after percutaneous coronary intervention. Circulation 117:3152–3156CrossRef
28.
Zurück zum Zitat Timmers L, Henriques JP, de Kleijn DP, Devries JH, Kemperman H, Steendijk P et al (2009) Exenatide reduces infarct size and improves cardiac function in a porcine model of ischemia and reperfusion injury. J Am Coll Cardiol 53:501–510CrossRef Timmers L, Henriques JP, de Kleijn DP, Devries JH, Kemperman H, Steendijk P et al (2009) Exenatide reduces infarct size and improves cardiac function in a porcine model of ischemia and reperfusion injury. J Am Coll Cardiol 53:501–510CrossRef
29.
Zurück zum Zitat Lonborg J, Vejlstrup N, Kelbaek H, Botker HE, Kim WY, Mathiasen AB et al (2012) Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction. Eur Heart J 33:1491–1499CrossRef Lonborg J, Vejlstrup N, Kelbaek H, Botker HE, Kim WY, Mathiasen AB et al (2012) Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction. Eur Heart J 33:1491–1499CrossRef
30.
Zurück zum Zitat Dokken BB, La Bonte LR, Davis-Gorman G, Teachey MK, Seaver N, McDonagh PF (2011) Glucagon-like peptide-1 (GLP-1), immediately prior to reperfusion, decreases neutrophil activation and reduces myocardial infarct size in rodents. Horm Metab Res 43:300–305CrossRef Dokken BB, La Bonte LR, Davis-Gorman G, Teachey MK, Seaver N, McDonagh PF (2011) Glucagon-like peptide-1 (GLP-1), immediately prior to reperfusion, decreases neutrophil activation and reduces myocardial infarct size in rodents. Horm Metab Res 43:300–305CrossRef
31.
Zurück zum Zitat Wang JW, Chen YD, Wang CH, Yang XC, Zhu XL, Zhou ZQ (2013) Development and validation of a clinical risk score predicting the no-reflow phenomenon in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Cardiology 124:153–160CrossRef Wang JW, Chen YD, Wang CH, Yang XC, Zhu XL, Zhou ZQ (2013) Development and validation of a clinical risk score predicting the no-reflow phenomenon in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Cardiology 124:153–160CrossRef
32.
Zurück zum Zitat Monami M, Dicembrini I, Nardini C, Fiordelli I, Mannucci E (2014) Effects of glucagon-like peptide-1 receptor agonists on cardiovascular risk: a meta-analysis of randomized clinical trials. Diabetes Obes Metab 16:38–47CrossRef Monami M, Dicembrini I, Nardini C, Fiordelli I, Mannucci E (2014) Effects of glucagon-like peptide-1 receptor agonists on cardiovascular risk: a meta-analysis of randomized clinical trials. Diabetes Obes Metab 16:38–47CrossRef
33.
Zurück zum Zitat Hirshberg B, Katz A (2015) Insights from cardiovascular outcome trials with novel antidiabetes agents: what have we learned? An industry perspective. Curr Diab Rep 15:87CrossRef Hirshberg B, Katz A (2015) Insights from cardiovascular outcome trials with novel antidiabetes agents: what have we learned? An industry perspective. Curr Diab Rep 15:87CrossRef
Metadaten
Titel
Efficacy of liraglutide intervention in myocardial infarction
A meta-analysis of randomized controlled trials
verfasst von
X. Yang
Z. Liang
Publikationsdatum
22.11.2018
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 5/2020
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-018-4748-5

Weitere Artikel der Ausgabe 5/2020

Herz 5/2020 Zur Ausgabe

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.