The Influence of Liraglutide for Heart Failure: A Meta-Analysis of Randomized Controlled Trials

Yu Zhang; Qingmei Chen; Guangyin Huang; Lisha Wang

doi:10.1532/hsf.2513

October 14, 2019The Heart Surgery ForumOpen Access

The Influence of Liraglutide for Heart Failure: A Meta-Analysis of Randomized Controlled Trials

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Why the study?

The efficacy of liraglutide to treat heart failure remains controversial.

Does liraglutide improve cardiac function and clinical outcomes in patients with heart failure?

Structured PICO

Does liraglutide improve cardiac function and clinical outcomes in patients with heart failure?

P

Population

629 patients with heart failure pooled from 4 randomized controlled trials

I

Intervention

Liraglutide

C

Comparator

Control group

O

Outcome

Cardiac function (NT-proBNP and 6-minute walk test)surrogate

In a meta-analysis of 4 RCTs, liraglutide improved surrogate markers of heart failure (NT-proBNP and 6MWT) but did not significantly reduce hard clinical outcomes like heart failure hospitalization or cardiac death.

Implication

Liraglutide may improve functional status and biomarkers in HF; extends RCT evidence on NT-proBNP reduction while leaving LVEF effects open.

Abstract

INTRODUCTION: The efficacy of liraglutide to treat heart failure remains controversial. We conducted a systematic review and meta-analysis to explore the influence of liraglutide on heart failure. METHODS: We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases through March 2018 for randomized controlled trials (RCTs) assessing the effect of liraglutide on cardiac function of heart failure. Meta-analysis is performed using the random-effect model. RESULTS: Four RCTs involving 629 patients are included in the meta-analysis. Overall, compared with the control group for heart failure, liraglutide treatment significantly can reduce NT-proBNP (Std. MD = -3.06; 95% CI = -5.78 to -0.34; P = .03), and improve 6MWT (Std. MD=1.10; 95% CI = 0.75 to 1.44; P < .00001), but has no remarkable influence on LVEF change (Std. MD=1.10; 95% CI = -1.97 to 3.98; P = 0.51), LVEDV change (Std. MD = 6.26; 95% CI = -1.45 to 13.97; P = .11), LVESV change (Std. MD = -13.47; 95% CI = -31.04 to 4.10; P = .13), hospitalization for heart failure (RR = 1.18; 95% CI = 0.88 to 1.58; P = .27), major adverse cardiovascular events (RR = 1.55; 95% CI = -0.24 to 9.89; P = .64), and cardiac death (RR = 1.11; 95% CI = 0.61 to 2.04; P = .72). CONCLUSIONS: Liraglutide treatment has an important ability to reduce NT-proBNP and improve 6MWT for heart failure, but shows no important influence on LVEF, LVEDV, LVESV, hospitalization for heart failure, major adverse cardiovascular events, and cardiac death.