GLP-1 in patients with myocardial infarction complicated by cardiogenic shock-an IABP-SHOCK II-substudy.
Clin Res Cardiol
; 113(8): 1211-1218, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38170249
ABSTRACT
BACKGROUND:
Glucagon-like peptide-1 (GLP-1) is a gut-derived peptide secreted in response to nutritional and inflammatory stimuli. Elevated GLP-1 levels predict adverse outcome in patients with acute myocardial infarction or sepsis. GLP-1 holds cardioprotective effects and GLP-1 receptor agonists reduce cardiovascular events in high-risk patients with diabetes. In this study, we aimed to investigate the capacity of GLP-1 to predict outcome in patients with cardiogenic shock (CS) complicating myocardial infarction.METHODS:
Circulating GLP-1 levels were serially assessed in 172 individuals during index PCI and day 2 in a prospectively planned biomarker substudy of the IABP-SHOCK II trial. All-cause mortality at short- (30 days), intermediate- (1 year), and long-term (6 years) follow-up was used for outcome assessment.RESULTS:
Patients with fatal short-term outcome (n = 70) exhibited higher GLP-1 levels [86 (interquartile range 45-130) pM] at ICU admission in comparison to patients with 30-day survival [48 (interquartile range 33-78) pM; p < 0.001] (n = 102). Repeated measures ANOVA revealed a significant interaction of GLP-1 dynamics from baseline to day 2 between survivors and non-survivors (p = 0.04). GLP-1 levels above vs. below the median proved to be predictive for short- [hazard ratio (HR) 2.43; 95% confidence interval (CI) 1.50-3.94; p < 0.001], intermediate- [HR 2.46; 95% CI 1.62-3.76; p < 0.001] and long-term [HR 2.12; 95% CI 1.44-3.11; p < 0.001] outcome by multivariate Cox-regression analysis.CONCLUSION:
Elevated plasma levels of GLP-1 are an independent predictor for impaired prognosis in patients with myocardial infarction complicated by CS. The functional relevance of GLP-1 in this context is currently unknown and needs further investigations. TRIAL REGISTRATION www. CLINICALTRIALS gov Identifier NCT00491036.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Shock, Cardiogenic
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Biomarkers
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Glucagon-Like Peptide 1
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Myocardial Infarction
Type of study:
Prognostic_studies
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Clin Res Cardiol
/
Clin. res. cardiol
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Clinical research in cardiology
Journal subject:
CARDIOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: