Infusion of GLP-1 improved recovery of LV function at 30 minutes after coronary balloon occlusion compared with saline (delta dP/dt(max) from baseline, -1.6% vs -12.2%; P=0.02).
RCT (n=20)
Does GLP-1 infusion reduce ischemic LV dysfunction and attenuate stunning in patients undergoing elective PCI?
In a pilot study, GLP-1 infusion reduced ischemic LV dysfunction and mitigated myocardial stunning after supply ischemia during coronary balloon occlusion in humans.
Tasa de eventos absoluta: -1.6% vs -12.2%
valor p: p=0.02
BACKGROUND: The incretin hormone glucagon-like peptide-1 (GLP-1) has been shown to have cardioprotective properties in animal models of ischemia and infarction due to promotion of myocardial glucose uptake and suppression of apoptosis. We investigated whether GLP-1 protected the heart from dysfunction caused by supply ischemia during percutaneous coronary intervention (PCI). METHODS AND RESULTS: Twenty patients with normal left ventricular (LV) function and single-vessel coronary disease within the left anterior descending artery undergoing elective PCI were studied. A conductance catheter was placed into the LV through the femoral artery, and pressure-volume loops were recorded at baseline and during a 1-minute low-pressure balloon occlusion at the site of the stenosis. The patients were randomized to receive an infusion of either GLP-1(7-36) amide at 1.2 pmol/kg per minute or saline immediately after the first balloon occlusion. Coronary balloon occlusion caused LV stunning in the control group with cumulative LV dysfunction on subsequent occlusion that was not seen in the GLP-1 group. GLP-1 improved recovery of LV systolic and diastolic function at 30 minutes after balloon occlusion compared with control (delta dP/dt(max) from baseline, -1.6% versus -12.2%; P=0.02) and reduced the LV dysfunction after the second balloon occlusion (delta dP/dt(max), -13.1% versus -25.3%; P=0.01). CONCLUSIONS: In this pilot study, infusion of GLP-1 has been demonstrated to reduce ischemic LV dysfunction after supply ischemia during coronary balloon occlusion in humans and mitigates stunning. The findings require confirmation in a larger scale clinical trial. CLINICAL TRIAL REGISTRATION: URL: http://www.isrctn.org. Unique identifier: ISRCTN 77442023.
Read et al. (Wed,) conducted a rct in single-vessel coronary disease (n=20). GLP-1(7-36) amide vs. saline was evaluated on recovery of LV systolic and diastolic function at 30 minutes after balloon occlusion (delta dP/dt(max) from baseline) (p=0.02). Infusion of GLP-1 improved recovery of LV function at 30 minutes after coronary balloon occlusion compared with saline (delta dP/dt(max) from baseline, -1.6% vs -12.2%; P=0.02).