Association of Antidiabetic Medications Targeting the Glucagon-Like Peptide 1 Pathway and Heart Failure Events in Patients With Diabetes

作者：Velez Mauricio; Peterson Edward L; Wells Karen; Swadia Tanmay; Sabbah Hani N; Williams L Keoki; Lanfear David E^*

来源：Journal of Cardiac Failure, 2015, 21(1): 2-8.

DOI：10.1016/j.cardfail.2014.10.012

• GLP-1 agonist
• DPP-4 inhibitor
• heart failure
• outcomes

Background: Glucagon-like peptide-1 (GLP-1) agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors (GLP-1 agents) may be protective in heart failure (HF). We set out to determine whether GLP-1 agent use is associated with HF risk in diabetics.
Methods and Results: In this retrospective cohort study of members of a large health system, we identified > 19,000 adult diabetics from January 1, 2000, to July 1, 2012. GLP-1 agent users were matched 1:2 to control subjects with the use of propensity matching based on age, race, sex, coronary disease, HF, diabetes duration, and number of antidiabetic medications. The association of GLP-1 agents with time to HF hospitalization was tested with multivariable Cox regression. All-cause hospitalization and mortality were secondary end points. We identified 1,426 users of GLP-1 agents and 2,798 control subjects. Both were similar except for angiotensin-converting enzyme inhibitors/angiotensin receptor blocker use, number of antidiabetic medications, and age. There were 199 hospitalizations, of which 128 were for HF, and 114 deaths. GLP-1 agents were associated with reduced risk of HF hospitalization (adjusted hazard ratio [aBR] 0.51, 95% confidence interval [CI] 0.34-0.77; P = .002), all-cause hospitalization (aHR 0.54, 95% CI 0.38-0.74; P = .001), and death (aHR 0.31, 95% CI 0.18-0.53; P = .001).
Conclusions: GLP-1 agents may reduce the risk of HF events in diabetics.

• 出版日期2015-1