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Myocardial Infarction Subtypes in Patients With Type 2 Diabetes Mellitus and the Effect of Liraglutide Therapy (from the LEADER Trial)

The American journal of cardiology, 2018-06, Vol.121 (12), p.1467-1470 [Peer Reviewed Journal]

2018 The Author(s) ;Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Sequoia S.A. Jun 15, 2018 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2018.02.030 ;PMID: 29627109

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Title:
Myocardial Infarction Subtypes in Patients With Type 2 Diabetes Mellitus and the Effect of Liraglutide Therapy (from the LEADER Trial)
Author: Marso, Steven P. ; Nauck, Michael A. ; Monk Fries, Tea ; Rasmussen, Søren ; Treppendahl, Marianne Bach ; Buse, John B.
Subjects: Arteries ; Calcium-binding protein ; Cardiovascular disease ; Cardiovascular diseases ; Carotid artery ; Carotid Stenosis - epidemiology ; Cerebral infarction ; Coronary artery ; Coronary Stenosis - epidemiology ; Coronary vessels ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - epidemiology ; Double-Blind Method ; Extremities ; Health risks ; Heart attacks ; Heart surgery ; Humans ; Incidence ; Incretins - therapeutic use ; Liraglutide - therapeutic use ; Myocardial infarction ; Myocardial Infarction - blood ; Myocardial Infarction - classification ; Myocardial Infarction - epidemiology ; Non-ST Elevated Myocardial Infarction - blood ; Non-ST Elevated Myocardial Infarction - epidemiology ; Patients ; Peripheral Arterial Disease - epidemiology ; Risk factors ; ST Elevation Myocardial Infarction - blood ; ST Elevation Myocardial Infarction - epidemiology ; Stenosis ; Stroke ; Troponin ; Troponin - blood ; Veins & arteries
Is Part Of: The American journal of cardiology, 2018-06, Vol.121 (12), p.1467-1470
Description: Diabetes mellitus (DM) is a known risk factor for myocardial infarction (MI); however, data regarding MI subtypes in people with diabetes are limited. In the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial (n = 9,340), liraglutide significantly reduced the risk of major adverse cardiovascular (CV) events (composite of CV death, nonfatal MI, or nonfatal stroke) versus placebo in patients with type 2 DM and high CV risk. Liraglutide also reduced risk of first MI (292 events with liraglutide vs 339 with placebo). This post hoc analysis characterized MIs (first and recurrent) occurring in LEADER, by treatment arm and regarding incidence, outcome, subtype, and troponin levels. A total of 780 MIs (first and recurrent) were reported, with fewer in the liraglutide-treatment group than in the placebo-treatment group (359 vs 421, p = 0.022). Numerically fewer MIs were associated with CV death with liraglutide than with placebo (17 vs 28 fatal MIs, p = 0.28). Symptomatic MIs in both arms were mainly non–ST-segment elevation MI (555/641) and spontaneous MI (518/641). Numerically greater proportions of symptomatic MIs were associated with troponin levels ≤5× or ≤10× the upper reference limit with liraglutide versus placebo (p = 0.16 and p = 0.42, respectively). At baseline, more liraglutide-treated patients than placebo-treated patients with MI during the trial had a history of coronary artery bypass graft (p = 0.008), and fewer had peripheral arterial disease in the lower extremities (p = 0.005) and >50% stenosis of the coronary artery, the carotid artery, or other arteries (p = 0.044). In conclusion, this analysis showed that liraglutide reduces the incidence of MIs in patients with type 2 DM at high CV risk and may impact the clinical outcomes of MI.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9149
EISSN: 1879-1913
DOI: 10.1016/j.amjcard.2018.02.030
PMID: 29627109
Source: MEDLINE
ProQuest Central

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Myocardial Infarction Subtypes in Patients With Type 2 Diabetes Mellitus and the Effect of Liraglutide Therapy (from the LEADER Trial)

2018 The Author(s) ;Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Sequoia S.A. Jun 15, 2018 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2018.02.030 ;PMID: 29627109

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