Physicians' Academy for Cardiovascular Education

GLP-1 analog reduces major CV outcomes in patients with atherosclerotic poly-vascular disease

Effect of Liraglutide on Cardiovascular Events in Patients With Type 2 Diabetes Mellitus and Polyvascular Disease. Results of the LEADER Trial

Literature - Verma S, Bhatt DL, Bain SC, et al. - Circulation 2018;137:2179–2183

Introduction and methods

In the LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results) trial, the GLP-1 analog liraglutide reduced CV events in patients with type 2 diabetes mellitus (T2DM) at high CV risk [1].

In this post hoc analysis of LEADER, the effects of liraglutide were assessed in patients with or without atherosclerotic poly-vascular disease in more than 1 vascular bed (coronary, cerebrovascular, and peripheral).

LEADER was a randomized trial of liraglutide (1.8 mg or maximum tolerated dose) versus placebo in 9,340 patients with T2DM and high CV risk (median follow-up: 3.8 years). The primary outcome was MACE, a composite of CV death, nonfatal myocardial infarction, or nonfatal stroke. The key secondary outcome (expanded MACE) also included hospitalization for unstable angina, coronary revascularization, or hospitalization for heart failure.

Main results

Conclusion

In patients with T2DM and documented atherosclerotic CVD, the presence of poly-vascular disease was associated with a higher CV risk compared with single vascular disease patients. Liraglutide consistently reduced major CV outcomes in both groups.

References

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