Effects of Liraglutide on Myocardial Function After Cardiac Surgery: A Secondary Analysis of the Randomised Controlled GLOBE Trial

• Published in: Journal of clinical medicine Vol. 9; no. 3; p. 673
• Main Authors: Hulst, Abraham H, Visscher, Maarten J, Cherpanath, Thomas G V, van de Wouw, Lieke, Godfried, Marc B, Thiel, Bram, Gerritse, Bastiaan M, Scohy, Thierry V, Bouwman, R Arthur, Willemsen, Mark G A, Hollmann, Markus W, DeVries, J Hans, Preckel, Benedikt, Hermanides, Jeroen
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.03.2020; MDPI
• Subjects: Antidiabetics; Cardiac function; Cardiovascular disease; ck-mb; Clinical medicine; Coronary vessels; Creatinine; Data collection; Diabetes; Drug stores; echocardiography; Electronic health records; Glucose; Heart rate; Heart surgery; Insulin; Ischemia; left ventricular function; liraglutide; placebo; randomised controlled trial; troponin; liraglutide; Troponin; left ventricular function; echocardiography; CK-MB; randomised controlled trial; cardiac function; placebo
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm9030673

Previous studies demonstrated the cardioprotective properties of glucagon-like peptide-1 receptor agonists in patients with diabetes or cardiac disease. We investigated whether preoperative subcutaneous liraglutide improves myocardial function after cardiac surgery. We performed a pre-planned secondary analysis of adult patients undergoing cardiac surgery included in the GLOBE trial. Patients were randomised to receive 0.6 mg subcutaneous liraglutide on the evening before surgery and 1.2 mg after induction of anaesthesia, or matching placebo. Perioperative echocardiographic assessments, haemodynamic parameters, doses of vasoactive inotropic support and postoperative measurements of troponin, Creatine Kinase-MB , creatinine and lactate were compared between groups. The study population consisted of the entire intention-to-treat cohort of the GLOBE trial. In this study, 129 patients received liraglutide and 132 patients placebo. Baseline characteristics were comparable between groups. Postoperatively, 170 (65%) patients underwent echocardiography. In the liraglutide group, more patients had a normal left ventricular systolic function (68%, 59 patients) compared to placebo (53%, 44 patients), difference = 15%, 95%CI = 0-30, = 0.049. Assessment of the right ventricle revealed no difference in function. Patients receiving short-term preoperative liraglutide treatment better maintained normal myocardial function after cardiac surgery. This study warrants further evaluation of the potential beneficial effects of GLP-1 receptor agonists in cardiac surgery patients.