Abstract
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 [aHR] 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.
Key Words
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Article info
Publication history
Published online: October 27, 2014
Accepted:
October 21,
2014
Received in revised form:
October 6,
2014
Received:
March 19,
2014
Footnotes
All decisions regarding this manuscript were made by a guest editor.
Funding: National Heart, Lung, and Blood Institute (Lanfear: K23HL085124, R01HL103871; Williams: R01HL079055, R01HL118267), National Institute of Allergy and Infectious Diseases (Williams: R01AI079139, R01AI061774), and National Institute of Diabetes and Digestive and Kidney Diseases (Williams: R01DK064695).
See page 7 for disclosure information.
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© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
