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October 28, 2016European Journal of Heart Failure581 citationsOpen Access

Effect of liraglutide, a glucagon‐like peptide‐1 analogue, on left ventricular function in stable chronic heart failure patients with and without diabetes (LIVE)—a multicentre, double‐blind, randomised, placebo‐controlled trial

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AJAnders JorsalCKCaroline KistorpPHPernille Holmager

Key Result

Liraglutide did not improve left ventricular function compared to placebo in heart failure patients, but was linked to a higher heart rate and increased serious cardiac events (P=0.04).

Structured PICO

Does liraglutide improve left ventricular ejection fraction in stable chronic heart failure patients with and without diabetes?

P
Population
241 patients aged 30-85 years with stable chronic heart failure, reduced left ventricular ejection fraction (LVEF ≤45%), and NYHA functional class I-III, with and without type 2 diabetes, on stable, optimal pharmacological treatment for heart failure for a minimum of 3 months.
I
Intervention
Liraglutide 1.8 mg subcutaneous once daily (introduced at 0.6 mg/day and titrated up) for 24 weeks, added to optimal heart failure treatment.
C
Comparator
Matching placebo subcutaneous once daily for 24 weeks, added to optimal heart failure treatment.
O
Outcome
Change in LVEF from randomization to end of follow-up (24 weeks), determined by three-dimensional contrast-enhanced echocardiography.surrogate

Liraglutide did not improve left ventricular systolic function in stable HFrEF patients and was associated with an increased heart rate and a higher incidence of serious cardiac adverse events.

Limitations

  • Inclusion of non-diabetic patients with less pronounced metabolic derangement may have reduced the potential effect of liraglutide treatment on myocardial metabolism

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 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 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.

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Cite This Study

Jorsal et al. (2016) studied this question. Liraglutide did not improve left ventricular function compared to placebo in heart failure patients, but was linked to a higher heart rate and increased serious cardiac events (P=0.04).

synapsesocial.com/papers/6960145533e82041331c57fdhttps://doi.org/10.1002/ejhf.657
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