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Patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: Liraglutide associated with mild improvement in left ventricular ejection fraction

Several studies have shown that Exenatide protects against ischemia-reperfusion injury and improves cardiac function in patients with acute ST-segment elevation myocardial infarction ( STEMI ).
The effects of Liraglutide ( Victoza ), a glucagon-like peptide-1 ( GLP-1 ) analogue, on STEMI patients remain unclear.

Researchers planned to evaluate the effects of Liraglutide on left ventricular function after primary percutaneous coronary intervention ( PCI ) for STEMI.

A total of 92 patients were randomized 1:1 to receive either Liraglutide or placebo for 7 days. Study treatment was commenced 30 minutes before intervention ( 1.8 mg ) and maintained for 7 days after the procedure ( 0.6 mg for 2 days, 1.2 mg for 2 days, followed by 1.8 mg for 3 days ).
Eighty-five patients completed the trial.

Transthoracic echocardiography was used to assess left ventricular function.

At 3 months, the primary end point, a difference in change of left ventricular ejection fraction between the two groups was +4.1% ( 95% CI +1.1% to +6.9% ) (P less than 0.001 ).

There was a tendency for a lower rate of no-reflow in Liraglutide group that did not reach statistical significance ( 7% vs control group 15%, P = 0.20 ).

Liraglutide could significantly improve stress hyperglycemia ( P less than 0.05 ).

In addition, Liraglutide elicited favorable changes in markers of inflammation and endothelial function.

In conclusion, a short 7-day course of Liraglutide in STEMI patients treated with primary percutaneous coronary intervention is associated with mild improvement in left ventricular ejection fraction at 3 months. ( Xagena )

Wei Ren Chen et al, Am Heart J 2015: 845–854