Effects of Glucagon-Like Peptide-1 in Patients With Acute Myocardial Infarction and Left Ventricular Dysfunction After Successful Reperfusion
Abstract
Background— Glucose-insulin-potassium infusions are beneficial in uncomplicated patients with acute myocardial infarction (AMI) but are of unproven efficacy in AMI with left ventricular (LV) dysfunction because of volume requirements associated with glucose infusion. Glucagon-like peptide-1 (GLP-1) is a naturally occurring incretin with both insulinotropic and insulinomimetic properties that stimulate glucose uptake without the requirements for concomitant glucose infusion. Methods and Results— We investigated the safety and efficacy of a 72-hour infusion of GLP-1 (1.5 pmol/kg per minute) added to background therapy in 10 patients with AMI and LV ejection fraction (EF) <40% after successful primary angioplasty compared with 11 control patients. Echocardiograms were obtained after reperfusion and after the completion of the GLP-1 infusion. Baseline demographics and background therapy were similar, and both groups had severe LV dysfunction at baseline (LVEF=29±2%). GLP-1 significantly improved LVEF (from 29±2% to 39±2%, P <0.01), global wall motion score indexes (1.94±0.11→1.63±0.09, P <0.01), and regional wall motion score indexes (2.53±0.08→2.02±0.11, P <0.01) compared with control subjects. The benefits of GLP-1 were independent of AMI location or history of diabetes. GLP-1 was well tolerated, with only transient gastrointestinal effects. Conclusions— When added to standard therapy, GLP-1 infusion improved regional and global LV function in patients with AMI and severe systolic dysfunction after successful primary angioplasty.
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GLP-1 has beneficial effects on left ventricular function after acute myocardial infarction and on vasodilatation in healthy subjects and patients with type II DM and stable coronary disease.
“it has beneficial effects on left ventricular function after acute myocardial infarction (29) and on vasodilatation in healthy subjects and patients with type II DM and stable coronary disease (6, 32).”
From Effects of glucagon-like peptide-1, yohimbine, and nitrergic modulation on sympathetic and parasympathetic activity in humans (2008) · cites this paper as [29]
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- Authors
- Nikolaidis, L. A., Mankad, S., Sokos, G. G., Miske, G., Shah, A., Elahi, D., & Shannon, R. P.
- Affiliations
- Allegheny General Hospital (US)
- Venue
- Circulation
- Published
- 2004-03-02
- Volume
- 109
- Issue
- 8
- Pages
- 962-965
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1968315455
- Cited by
- 901
- References
- 15
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 25 · 2023: 18 · 2022: 17 · 2021: 25 · 2020: 27 · 2019: 38 · 2018: 37 · 2017: 46 · 2016: 48 · 2015: 63 · 2014: 71 · 2013: 80 · 2012: 92
- FWCI
- 16.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pittsburgh Foundation
- National Institutes of Health (5r01ag023125-05)
- National Institute on Aging (1 R01 AG023125)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Cardiac Ischemia and Reperfusion
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- glucagon-like peptide-1, acute myocardial infarction, left ventricular dysfunction, primary percutaneous coronary intervention, reperfusion, left ventricular ejection fraction, regional wall motion, incretin-based therapy, glucose-insulin-potassium infusion, systolic dysfunction
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Glucose, Combined Modality Therapy, Glucagon-Like Peptides, Female, Glucagon, Humans, Male, Middle Aged, Myocardial Infarction, Peptide Fragments, Pilot Projects, Safety, Stroke Volume, Angioplasty, Balloon, Coronary, Ventricular Function, Left, Treatment Outcome, Diabetes Complications, Glucagon-Like Peptide 1
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