Key result
Preoperative liraglutide better maintained normal left ventricular systolic function after cardiac surgery compared to placebo (68% vs 53%, difference 15%; 95% CI 0-30; P=0.049).
Why the study?
GLP-1 receptor agonists have demonstrated cardioprotective properties in diabetes or cardiac disease, but whether preoperative subcutaneous liraglutide improves myocardial function after cardiac surgery was unknown.
Does preoperative subcutaneous liraglutide improve myocardial function after cardiac surgery in adult patients?
RCT (n=261)
Placebo-controlled
Randomized
Does preoperative subcutaneous liraglutide improve myocardial function after cardiac surgery in adult patients?
Effect estimate: difference 15% (95% CI 0-30)
Absolute Event Rate: 68% vs 53%
p-value: p=0.049
Short-term preoperative liraglutide treatment may help maintain normal left ventricular systolic function after cardiac surgery.
Supports preoperative liraglutide to preserve LV systolic function after cardiac surgery; extends RCT evidence for GLP-1 agonists in perioperative settings.
Introduction: 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. Methods: 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. Results: 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, p = 0.049. Assessment of the right ventricle revealed no difference in function. Conclusions: 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.
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Hulst et al. (2020) conducted an RCT in Cardiac surgery (n=261). Liraglutide vs. Placebo was evaluated on Normal left ventricular systolic function postoperatively (difference 15%, 95% CI 0-30, p=0.049). Preoperative liraglutide better maintained normal left ventricular systolic function after cardiac surgery compared to placebo (68% vs 53%, difference 15%; 95% CI 0-30; P=0.049).
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