Anders Jorsal1,2, Caroline Kistorp3,4, Pernille Holmager3, Rasmus Stilling Tougaard1,2, Roni Nielsen1,2, Anja Hänselmann5, Brian Nilsson6, Jacob Eifer Møller5, Jakob Hjort2, Jon Rasmussen3,4, Trine Welløv Boesgaard7, Morten Schou4,8, Lars Videbaek5, Ida Gustafsson6, Allan Flyvbjerg2,9,10, Henrik Wiggers1,2, Lise Tarnow7,9,11. 1. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. 2. Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. 3. Department of Endocrinology and Internal Medicine, Herlev University Hospital, Copenhagen, Denmark. 4. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 5. Department of Cardiology, Odense University Hospital, Odense, Denmark. 6. Department of Cardiology, Hvidovre University Hospital, Copenhagen, Denmark. 7. Steno Diabetes Center, Gentofte, Denmark. 8. Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark. 9. Faculty of Health, Aarhus University, Aarhus, Denmark. 10. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. 11. Nordsjaellands University Hospital, Hillerød, Denmark.
Abstract
AIMS: To determine the effect of the glucagon-like peptide-1 analogue liraglutide on left ventricular function in chronic heart failure patients with and without type 2 diabetes. METHODS AND RESULTS: LIVE was an investigator-initiated, randomised, double-blinded, placebo-controlled multicentre trial. Patients (n = 241) with reduced left ventricular ejection fraction (LVEF ≤45%) were recruited (February 2012 to August 2015). Patients were clinically stable and on optimal heart failure treatment. Intervention was liraglutide 1.8 mg once daily or matching placebo for 24 weeks. The LVEF was similar at baseline in the liraglutide and the placebogroup (33.7 ± 7.6% vs. 35.4 ± 9.4%). Change in LVEF did not differ between the liraglutide and the placebogroup; mean difference (95% confidence interval) was -0.8% (-2.1, 0.5; P = 0.24). Heart rate increased with liraglutide [mean difference: 7 b.p.m. (5, 9), P < 0.0001]. Serious cardiac events were seen in 12 (10%) patients treated with liraglutide compared with 3 (3%) patients in the placebogroup (P = 0.04). CONCLUSION:Liraglutide did not affect left ventricular systolic function compared with placebo in stable chronic heart failure patients with and without diabetes. Treatment with liraglutide was associated with an increase in heart rate and more serious cardiac adverse events, and this raises some concern with respect to the use of liraglutide in patients with chronic heart failure and reduced left ventricular function. More data on the safety of liraglutide in different subgroups of heart failure patients are needed.
RCT Entities:
AIMS: To determine the effect of the glucagon-like peptide-1 analogue liraglutide on left ventricular function in chronic heart failurepatients with and without type 2 diabetes. METHODS AND RESULTS: LIVE was an investigator-initiated, randomised, double-blinded, placebo-controlled multicentre trial. Patients (n = 241) with reduced left ventricular ejection fraction (LVEF ≤45%) were recruited (February 2012 to August 2015). Patients were clinically stable and on optimal heart failure treatment. Intervention was liraglutide 1.8 mg once daily or matching placebo for 24 weeks. The LVEF was similar at baseline in the liraglutide and the placebo group (33.7 ± 7.6% vs. 35.4 ± 9.4%). Change in LVEF did not differ between the liraglutide and the placebo group; mean difference (95% confidence interval) was -0.8% (-2.1, 0.5; P = 0.24). Heart rate increased with liraglutide [mean difference: 7 b.p.m. (5, 9), P < 0.0001]. Serious cardiac events were seen in 12 (10%) patients treated with liraglutide compared with 3 (3%) patients in the placebo group (P = 0.04). CONCLUSION: Liraglutide did not affect left ventricular systolic function compared with placebo in stable chronic heart failurepatients with and without diabetes. Treatment with liraglutide was associated with an increase in heart rate and more serious cardiac adverse events, and this raises some concern with respect to the use of liraglutide in patients with chronic heart failure and reduced left ventricular function. More data on the safety of liraglutide in different subgroups of heart failurepatients are needed.
Authors: Roni Nielsen; Anders Jorsal; Peter Iversen; Lars Poulsen Tolbod; Kirsten Bouchelouche; Jens Sørensen; Hendrik Johannes Harms; Allan Flyvbjerg; Lise Tarnow; Caroline Kistorp; Ida Gustafsson; Hans Erik Bøtker; Henrik Wiggers Journal: J Nucl Cardiol Date: 2017-08-02 Impact factor: 5.952
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