GLP-1 receptor agonists and cardiovascular outcome trials: An update

Dec 12, 2018Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese

Update on heart health results from GLP-1 receptor agonist treatments

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Abstract

Major cardiovascular outcome trials show glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven cardiovascular safety.

GLP-1 RAs may reduce the risk of major adverse cardiac events (MACE) with certain agents like liraglutide, semaglutide, and albiglutide.
Lixisenatide and extended-release exenatide appear to have a neutral effect on cardiovascular outcomes.
The cardioprotective effects of GLP-1 RAs are linked to multiple non-glycaemic actions, including improved insulin sensitivity, weight loss, and lower blood pressure.
Differences in drug-specific properties among GLP-1 RAs may exist, influencing their individual cardiovascular effects.

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Major cardiovascular (CV) outcome trials with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are currently available. These agonists have proven their CV safety, in harmony with the US Food and Drug Administration (FDA) recommendation for antidiabetic drugs. The potential cardioprotective effect of incretin-based therapies is attributed to their multiple non-glycaemic actions in the CV system, including changes in insulin resistance, weight loss, reduction in blood pressure, improved lipid profile and direct effects on the heart and vascular endothelium. Liraglutide, semaglutide and albiglutide have been demonstrated to reduce the risk of major adverse cardiac events (MACE), whereas lixisenatide and extended-release exenatide had a neutral effect. Thus, it is conceivable that there are different drug-specific properties across the class of GLP-1 RAs. In this review, we discuss the results of the five recently published randomised CV outcome trials with GLP-1 RAs, along with the potential differences and the pleiotropic actions of these agents on the CV system.

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GLP-1 receptor agonists and cardiovascular outcome trials: An update

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