Glucagon-like peptide 1 levels predict cardiovascular risk in patients with acute myocardial infarction
Abstract Aims Glucagon-like peptide 1 (GLP-1) is a gut incretin hormone inducing post-prandial insulin secretion. Glucagon-like peptide 1 levels were recently found to be increased in patients with acute myocardial infarction. Glucagon-like peptide 1 receptor agonists improve cardiovascular outcomes...
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| Veröffentlicht in: | European heart journal 2020-02, Vol.41 (7), p.882-889 |
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| creator | Kahles, Florian Rückbeil, Marcia V Mertens, Robert W Foldenauer, Ann C Arrivas, Maria C Moellmann, Julia Lebherz, Corinna Biener, Moritz Giannitsis, Evangelos Katus, Hugo A Marx, Nikolaus Lehrke, Michael |
| description | Abstract
Aims
Glucagon-like peptide 1 (GLP-1) is a gut incretin hormone inducing post-prandial insulin secretion. Glucagon-like peptide 1 levels were recently found to be increased in patients with acute myocardial infarction. Glucagon-like peptide 1 receptor agonists improve cardiovascular outcomes in patients with diabetes. The aim of this study was to assess the predictive capacity of GLP-1 serum levels for cardiovascular outcome in patients with myocardial infarction.
Methods and results
In 918 patients presenting with myocardial infarction [321 ST-segment elevation myocardial infarction and 597 non-ST-segment elevation myocardial infarction (NSTEMI)] total GLP-1, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the Global Registry of Acute Coronary Events (GRACE) score were assessed at time of hospital admission. The primary composite outcome of the study was the first occurrence of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke. Kaplan–Meier survival plots and univariable Cox regression analyses found GLP-1 to be associated with adverse outcome [hazard ratio (HR) of logarithmized GLP-1 values: 6.29, 95% confidence interval (CI): 2.67–14.81; P < 0.0001]. After further adjustment for age, sex, family history of cardiovascular disease, smoking, diabetes, hypertension, hypercholesterinaemia, glomerular filtration rate (GFR) CKD-EPI, hs-CRP, hs-Troponin T, and NT-proBNP levels the HR remained significant at 10.98 (95% CI: 2.63–45.90; P = 0.0010). Time-dependent receiver operating characteristic curve analyses illustrated that GLP-1 levels are a strong indicator for early events. For events up to 30 days after admission, GLP-1 proved to be superior to other biomarkers including hs-Troponin T, GFR CKD-EPI, hs-CRP, and NT-proBNP. Adjustment of the GRACE risk estimate by addition of GLP-1 increased the area under the receiver operating characteristic curve over time in NSTEMI patients.
Conclusion
In patients hospitalized for myocardial infarction, GLP-1 levels are associated with cardiovascular events. |
| doi_str_mv | 10.1093/eurheartj/ehz728 |
| format | Article |
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Aims
Glucagon-like peptide 1 (GLP-1) is a gut incretin hormone inducing post-prandial insulin secretion. Glucagon-like peptide 1 levels were recently found to be increased in patients with acute myocardial infarction. Glucagon-like peptide 1 receptor agonists improve cardiovascular outcomes in patients with diabetes. The aim of this study was to assess the predictive capacity of GLP-1 serum levels for cardiovascular outcome in patients with myocardial infarction.
Methods and results
In 918 patients presenting with myocardial infarction [321 ST-segment elevation myocardial infarction and 597 non-ST-segment elevation myocardial infarction (NSTEMI)] total GLP-1, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the Global Registry of Acute Coronary Events (GRACE) score were assessed at time of hospital admission. The primary composite outcome of the study was the first occurrence of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke. Kaplan–Meier survival plots and univariable Cox regression analyses found GLP-1 to be associated with adverse outcome [hazard ratio (HR) of logarithmized GLP-1 values: 6.29, 95% confidence interval (CI): 2.67–14.81; P < 0.0001]. After further adjustment for age, sex, family history of cardiovascular disease, smoking, diabetes, hypertension, hypercholesterinaemia, glomerular filtration rate (GFR) CKD-EPI, hs-CRP, hs-Troponin T, and NT-proBNP levels the HR remained significant at 10.98 (95% CI: 2.63–45.90; P = 0.0010). Time-dependent receiver operating characteristic curve analyses illustrated that GLP-1 levels are a strong indicator for early events. For events up to 30 days after admission, GLP-1 proved to be superior to other biomarkers including hs-Troponin T, GFR CKD-EPI, hs-CRP, and NT-proBNP. Adjustment of the GRACE risk estimate by addition of GLP-1 increased the area under the receiver operating characteristic curve over time in NSTEMI patients.
Conclusion
In patients hospitalized for myocardial infarction, GLP-1 levels are associated with cardiovascular events.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz728</identifier><identifier>PMID: 31620788</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Biomarkers ; Cardiovascular Diseases - etiology ; Glucagon-Like Peptide 1 ; Heart Disease Risk Factors ; Humans ; Myocardial Infarction ; Natriuretic Peptide, Brain ; Peptide Fragments ; Prognosis ; Risk Factors</subject><ispartof>European heart journal, 2020-02, Vol.41 (7), p.882-889</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c335t-551c89ee34bafb22c57b80e30e7cb3f370ab22ee069df6a7e3c542d71b59114e3</citedby><cites>FETCH-LOGICAL-c335t-551c89ee34bafb22c57b80e30e7cb3f370ab22ee069df6a7e3c542d71b59114e3</cites><orcidid>0000-0003-2484-8068 ; 0000-0003-0277-1282 ; 0000-0001-6742-5079 ; 0000-0001-6763-6538</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31620788$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kahles, Florian</creatorcontrib><creatorcontrib>Rückbeil, Marcia V</creatorcontrib><creatorcontrib>Mertens, Robert W</creatorcontrib><creatorcontrib>Foldenauer, Ann C</creatorcontrib><creatorcontrib>Arrivas, Maria C</creatorcontrib><creatorcontrib>Moellmann, Julia</creatorcontrib><creatorcontrib>Lebherz, Corinna</creatorcontrib><creatorcontrib>Biener, Moritz</creatorcontrib><creatorcontrib>Giannitsis, Evangelos</creatorcontrib><creatorcontrib>Katus, Hugo A</creatorcontrib><creatorcontrib>Marx, Nikolaus</creatorcontrib><creatorcontrib>Lehrke, Michael</creatorcontrib><title>Glucagon-like peptide 1 levels predict cardiovascular risk in patients with acute myocardial infarction</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Abstract
Aims
Glucagon-like peptide 1 (GLP-1) is a gut incretin hormone inducing post-prandial insulin secretion. Glucagon-like peptide 1 levels were recently found to be increased in patients with acute myocardial infarction. Glucagon-like peptide 1 receptor agonists improve cardiovascular outcomes in patients with diabetes. The aim of this study was to assess the predictive capacity of GLP-1 serum levels for cardiovascular outcome in patients with myocardial infarction.
Methods and results
In 918 patients presenting with myocardial infarction [321 ST-segment elevation myocardial infarction and 597 non-ST-segment elevation myocardial infarction (NSTEMI)] total GLP-1, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the Global Registry of Acute Coronary Events (GRACE) score were assessed at time of hospital admission. The primary composite outcome of the study was the first occurrence of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke. Kaplan–Meier survival plots and univariable Cox regression analyses found GLP-1 to be associated with adverse outcome [hazard ratio (HR) of logarithmized GLP-1 values: 6.29, 95% confidence interval (CI): 2.67–14.81; P < 0.0001]. After further adjustment for age, sex, family history of cardiovascular disease, smoking, diabetes, hypertension, hypercholesterinaemia, glomerular filtration rate (GFR) CKD-EPI, hs-CRP, hs-Troponin T, and NT-proBNP levels the HR remained significant at 10.98 (95% CI: 2.63–45.90; P = 0.0010). Time-dependent receiver operating characteristic curve analyses illustrated that GLP-1 levels are a strong indicator for early events. For events up to 30 days after admission, GLP-1 proved to be superior to other biomarkers including hs-Troponin T, GFR CKD-EPI, hs-CRP, and NT-proBNP. Adjustment of the GRACE risk estimate by addition of GLP-1 increased the area under the receiver operating characteristic curve over time in NSTEMI patients.
Conclusion
In patients hospitalized for myocardial infarction, GLP-1 levels are associated with cardiovascular events.</description><subject>Biomarkers</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Glucagon-Like Peptide 1</subject><subject>Heart Disease Risk Factors</subject><subject>Humans</subject><subject>Myocardial Infarction</subject><subject>Natriuretic Peptide, Brain</subject><subject>Peptide Fragments</subject><subject>Prognosis</subject><subject>Risk Factors</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1LwzAYh4Mobk7vniRHQery0aTtUYZOQfCi4K2k6dstW9bWJJ3Mv95q566eXnh5fs_hQeiSkltKMj6Fzi1BubCawvIrYekRGlPBWJTJWByjMaGZiKRM30fozPsVISSVVJ6iEaeSkSRNx2gxt51Wi6aOrFkDbqENpgRMsYUtWI9bB6XRAWvlStNsldedVQ4749fY1LhVwUAdPP40YYmV7gLgza75pZXtiUo5HUxTn6OTSlkPF_s7QW8P96-zx-j5Zf40u3uONOciREJQnWYAPC5UVTCmRVKkBDiBRBe84glR_ReAyKyspEqAaxGzMqGFyCiNgU_Q9eBtXfPRgQ_5xngN1qoams7njBMZZ6nIRI-SAdWu8d5BlbfObJTb5ZTkP3nzQ958yNtPrvb2rthAeRj89eyBmwFouvZ_3TdliYsn</recordid><startdate>20200214</startdate><enddate>20200214</enddate><creator>Kahles, Florian</creator><creator>Rückbeil, Marcia V</creator><creator>Mertens, Robert W</creator><creator>Foldenauer, Ann C</creator><creator>Arrivas, Maria C</creator><creator>Moellmann, Julia</creator><creator>Lebherz, Corinna</creator><creator>Biener, Moritz</creator><creator>Giannitsis, Evangelos</creator><creator>Katus, Hugo A</creator><creator>Marx, Nikolaus</creator><creator>Lehrke, Michael</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2484-8068</orcidid><orcidid>https://orcid.org/0000-0003-0277-1282</orcidid><orcidid>https://orcid.org/0000-0001-6742-5079</orcidid><orcidid>https://orcid.org/0000-0001-6763-6538</orcidid></search><sort><creationdate>20200214</creationdate><title>Glucagon-like peptide 1 levels predict cardiovascular risk in patients with acute myocardial infarction</title><author>Kahles, Florian ; Rückbeil, Marcia V ; Mertens, Robert W ; Foldenauer, Ann C ; Arrivas, Maria C ; Moellmann, Julia ; Lebherz, Corinna ; Biener, Moritz ; Giannitsis, Evangelos ; Katus, Hugo A ; Marx, Nikolaus ; Lehrke, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-551c89ee34bafb22c57b80e30e7cb3f370ab22ee069df6a7e3c542d71b59114e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Biomarkers</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Glucagon-Like Peptide 1</topic><topic>Heart Disease Risk Factors</topic><topic>Humans</topic><topic>Myocardial Infarction</topic><topic>Natriuretic Peptide, Brain</topic><topic>Peptide Fragments</topic><topic>Prognosis</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kahles, Florian</creatorcontrib><creatorcontrib>Rückbeil, Marcia V</creatorcontrib><creatorcontrib>Mertens, Robert W</creatorcontrib><creatorcontrib>Foldenauer, Ann C</creatorcontrib><creatorcontrib>Arrivas, Maria C</creatorcontrib><creatorcontrib>Moellmann, Julia</creatorcontrib><creatorcontrib>Lebherz, Corinna</creatorcontrib><creatorcontrib>Biener, Moritz</creatorcontrib><creatorcontrib>Giannitsis, Evangelos</creatorcontrib><creatorcontrib>Katus, Hugo A</creatorcontrib><creatorcontrib>Marx, Nikolaus</creatorcontrib><creatorcontrib>Lehrke, Michael</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kahles, Florian</au><au>Rückbeil, Marcia V</au><au>Mertens, Robert W</au><au>Foldenauer, Ann C</au><au>Arrivas, Maria C</au><au>Moellmann, Julia</au><au>Lebherz, Corinna</au><au>Biener, Moritz</au><au>Giannitsis, Evangelos</au><au>Katus, Hugo A</au><au>Marx, Nikolaus</au><au>Lehrke, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glucagon-like peptide 1 levels predict cardiovascular risk in patients with acute myocardial infarction</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2020-02-14</date><risdate>2020</risdate><volume>41</volume><issue>7</issue><spage>882</spage><epage>889</epage><pages>882-889</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Aims
Glucagon-like peptide 1 (GLP-1) is a gut incretin hormone inducing post-prandial insulin secretion. Glucagon-like peptide 1 levels were recently found to be increased in patients with acute myocardial infarction. Glucagon-like peptide 1 receptor agonists improve cardiovascular outcomes in patients with diabetes. The aim of this study was to assess the predictive capacity of GLP-1 serum levels for cardiovascular outcome in patients with myocardial infarction.
Methods and results
In 918 patients presenting with myocardial infarction [321 ST-segment elevation myocardial infarction and 597 non-ST-segment elevation myocardial infarction (NSTEMI)] total GLP-1, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the Global Registry of Acute Coronary Events (GRACE) score were assessed at time of hospital admission. The primary composite outcome of the study was the first occurrence of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke. Kaplan–Meier survival plots and univariable Cox regression analyses found GLP-1 to be associated with adverse outcome [hazard ratio (HR) of logarithmized GLP-1 values: 6.29, 95% confidence interval (CI): 2.67–14.81; P < 0.0001]. After further adjustment for age, sex, family history of cardiovascular disease, smoking, diabetes, hypertension, hypercholesterinaemia, glomerular filtration rate (GFR) CKD-EPI, hs-CRP, hs-Troponin T, and NT-proBNP levels the HR remained significant at 10.98 (95% CI: 2.63–45.90; P = 0.0010). Time-dependent receiver operating characteristic curve analyses illustrated that GLP-1 levels are a strong indicator for early events. For events up to 30 days after admission, GLP-1 proved to be superior to other biomarkers including hs-Troponin T, GFR CKD-EPI, hs-CRP, and NT-proBNP. Adjustment of the GRACE risk estimate by addition of GLP-1 increased the area under the receiver operating characteristic curve over time in NSTEMI patients.
Conclusion
In patients hospitalized for myocardial infarction, GLP-1 levels are associated with cardiovascular events.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31620788</pmid><doi>10.1093/eurheartj/ehz728</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2484-8068</orcidid><orcidid>https://orcid.org/0000-0003-0277-1282</orcidid><orcidid>https://orcid.org/0000-0001-6742-5079</orcidid><orcidid>https://orcid.org/0000-0001-6763-6538</orcidid></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Biomarkers Cardiovascular Diseases - etiology Glucagon-Like Peptide 1 Heart Disease Risk Factors Humans Myocardial Infarction Natriuretic Peptide, Brain Peptide Fragments Prognosis Risk Factors |
| title | Glucagon-like peptide 1 levels predict cardiovascular risk in patients with acute myocardial infarction |
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