Abstract
Background: Whether liraglutide use improves cardiometabolic risk factors in different subsets of subjects with coronary artery disease (CAD) remains unclear. In a systematic review and meta-analysis, we quantified the effects of liraglutide on cardiometabolic risk profile in subjects with CAD with or without type 2 diabetes mellitus (T2D). Methods: Online database searches were conducted in PubMed, Scopus, EMBASE, Web of Science, Cochrane library, and Google Scholar from incept up to 15th January 2021. We identified randomized controlled trials (RCTs) assessing the effects of liraglutide compared to placebo on cardiometabolic risk profile. We used the random- or fixed-effect models to pool the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Results: Out of a total of 7,320 citations, six articles (seven RCTs) with 294 subjects with CAD (mean age, 61.21 years; 19% women) were included. Our findings presented as WMD and 95% CI showed a statistical significant decrease in hemoglobin A1c (HbA1c) [−0.36%; −0.47; −0.26, p < 0.001; I 2 = 0.0% (with 6 RCTs)], body mass index (BMI) [−0.61 kg/m2; −1.21; −0.01, p = 0.047; I 2 = 72.2% (with five RCTs)], and waist circumference [−2.41 cm; −3.47; −1.36, p < 0.001; I 2 = 0.0% (with three RCTs)]. Through a set of subgroup analyses, we found a significant reduction in BMI in CAD patients with T2D [WMD = −1.06; 95% CI, −1.42, −0.70, p < 0.001; I 2 = 0.0% (with three RCTs)] compared to CAD only patients [WMD = −0.08; 95% CI, −0.45, 0.29, p = 0.66; I 2 = 0.0% (with two RCTs)] in the liraglutide group compared with the placebo group. No significant changes in heart rate, blood pressure, and lipid profiles were observed. Conclusions: Among people with established CAD, liraglutide significantly improved HbA1c, BMI, and waist circumference values. The effect of liraglutide on BMI was more robust in individuals with T2D compared to those without.
Highlights
Liraglutide is an analog of human native incretin hormone with 97% similarity and is known as a long-acting glucagon-like peptide 1 receptor agonist (GLP1-RA) (Howell et al, 2019)
Using fixed-effect model, our meta-analyses showed a significant decrease in the weighted mean differences (WMDs) of hemoglobin A1c (HbA1c) [WMD −0.36%; 95% confidence intervals (CIs), −0.47; −0.26, p < 0.001; I2 0.0%], and waist circumference (WC) [WMD −2.41 cm; 95% CI, -3.47; - 1.36, p < 0.001; I2 0.0%], and according to random-effects model, a significant decrease in the WMD of body mass index (BMI) [WMD −0.61 kg/m2; 95% CI, −1.21; −0.01, p 0.047; I2 72.2%] in the liraglutide group compared with the placebo group
We found a significant difference between the two groups in whichCAD patients with type 2 diabetes mellitus (T2D) had significantly more reduction in BMI [WMD −1.06 kg/ m2; 95% CI, v1.42; −0.70, p < 0.001; I2 0.0%] compared to Coronary artery disease (CAD) only patients [WMD −0.08 kg/m2; 95% CI, −0.45; 0.29, p 0.660; I2 0.0%]
Summary
Liraglutide is an analog of human native incretin hormone with 97% similarity and is known as a long-acting glucagon-like peptide 1 receptor agonist (GLP1-RA) (Howell et al, 2019). Liraglutide can be considered inT2D patients aged 55 years or older and high risk of CVD, even without established atherosclerotic cardiovascular disease (ASCVD), to reduce the risk of major adverse cardiovascular events (MACE) (Buse et al, 2020). Optimal treatment of CAD leads to improve patients’ survival rates for many years and decrease the disease progression and complications (Malavolta et al, 2017). Whether liraglutide use improves cardiometabolic risk factors in different subsets of subjects with coronary artery disease (CAD) remains unclear. In a systematic review and meta-analysis, we quantified the effects of liraglutide on cardiometabolic risk profile in subjects with CAD with or without type 2 diabetes mellitus (T2D)
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