Published online before print February 23, 2004, doi: 10.1161/01.CIR.0000120505.91348.58
(Circulation. 2004;109:962-965.)
© 2004 American Heart Association, Inc.
Brief Rapid Communications |
Effects of Glucagon-Like Peptide-1 in Patients With Acute Myocardial Infarction and Left Ventricular Dysfunction After Successful Reperfusion
From the Cardiovascular Research Institute, Allegheny General Hospital, Pittsburgh, Pa (L.A.N., S.M., G.G.S., G.M., A.S., R.P.S.), and the University of Massachusetts Medical Center, Worcester, Mass (D.E.).
Correspondence to Dr Richard P. Shannon, Department of Medicine, Allegheny General Hospital, 320 E North Avenue, Pittsburgh, PA 15212. E-mail rshannon{at}wpahs.org
Received October 9, 2003; de novo received November 21, 2003; revision received January 13, 2004; accepted January 14, 2004.
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±0.082.02±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.
Key Words: myocardial infarction • insulin • heart failure • angioplasty
This article has been cited by other articles:
 |
|
 |
|
  K. Ban, M. H. Noyan-Ashraf, J. Hoefer, S.-S. Bolz, D. J. Drucker, and M. Husain Cardioprotective and Vasodilatory Actions of Glucagon-Like Peptide 1 Receptor Are Mediated Through Both Glucagon-Like Peptide 1 Receptor-Dependent and -Independent Pathways Circulation, May 6, 2008; 117(18): 2340 - 2350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. H. Opie Metabolic Management of Acute Myocardial Infarction Comes to the Fore and Extends Beyond Control of Hyperglycemia Circulation, April 29, 2008; 117(17): 2172 - 2177. [Full Text] [PDF]
|
|
|
|
 |
|
 O. Schmitz The GLP-1 Concept in the Treatment of Type 2 Diabetes--Still Standing at the Gate of Dawn? J. Clin. Endocrinol. Metab., February 1, 2008; 93(2): 375 - 377. [Full Text] [PDF]
|
|
|
|
|
|
S. E. Inzucchi and D. K. McGuire New Drugs for the Treatment of Diabetes: Part II: Incretin-Based Therapy and Beyond Circulation, January 29, 2008; 117(4): 574 - 584. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Basu, N. Charkoudian, W. Schrage, R. A. Rizza, R. Basu, and M. J. Joyner Beneficial effects of GLP-1 on endothelial function in humans: dampening by glyburide but not by glimepiride Am J Physiol Endocrinol Metab, November 1, 2007; 293(5): E1289 - E1295. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Holst The Physiology of Glucagon-like Peptide 1 Physiol Rev, October 1, 2007; 87(4): 1409 - 1439. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Yellon and D. J. Hausenloy Myocardial Reperfusion Injury N. Engl. J. Med., September 13, 2007; 357(11): 1121 - 1135. [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Donahoe, G. C. Stewart, C. H. McCabe, S. Mohanavelu, S. A. Murphy, C. P. Cannon, and E. M. Antman Diabetes and Mortality Following Acute Coronary Syndromes JAMA, August 15, 2007; 298(7): 765 - 775. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Zhao, P. Parikh, S. Bhashyam, H. Bolukoglu, I. Poornima, Y.-T. Shen, and R. P. Shannon Direct Effects of Glucagon-Like Peptide-1 on Myocardial Contractility and Glucose Uptake in Normal and Postischemic Isolated Rat Hearts J. Pharmacol. Exp. Ther., June 1, 2006; 317(3): 1106 - 1113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Riddle and D. J. Drucker Emerging Therapies Mimicking the Effects of Amylin and Glucagon-Like Peptide 1 Diabetes Care, February 1, 2006; 29(2): 435 - 449. [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Nikolaidis, D. Elahi, Y.-T. Shen, and R. P. Shannon Active metabolite of GLP-1 mediates myocardial glucose uptake and improves left ventricular performance in conscious dogs with dilated cardiomyopathy Am J Physiol Heart Circ Physiol, December 1, 2005; 289(6): H2401 - H2408. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Tsang, D. J. Hausenloy, and D. M. Yellon Myocardial postconditioning: reperfusion injury revisited Am J Physiol Heart Circ Physiol, July 1, 2005; 289(1): H2 - H7. [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Bose, M. M. Mocanu, R. D. Carr, C. L. Brand, and D. M. Yellon Glucagon-like Peptide 1 Can Directly Protect the Heart Against Ischemia/Reperfusion Injury Diabetes, January 1, 2005; 54(1): 146 - 151. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Nikolaidis, A. Doverspike, T. Hentosz, L. Zourelias, Y.-T. Shen, D. Elahi, and R. P. Shannon Glucagon-Like Peptide-1 Limits Myocardial Stunning following Brief Coronary Occlusion and Reperfusion in Conscious Canines J. Pharmacol. Exp. Ther., January 1, 2005; 312(1): 303 - 308. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Nystrom, M. K. Gutniak, Q. Zhang, F. Zhang, J. J. Holst, B. Ahren, and A. Sjoholm Effects of glucagon-like peptide-1 on endothelial function in type 2 diabetes patients with stable coronary artery disease Am J Physiol Endocrinol Metab, December 1, 2004; 287(6): E1209 - E1215. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Taegtmeyer Cardiac Metabolism as a Target for the Treatment of Heart Failure Circulation, August 24, 2004; 110(8): 894 - 896. [Full Text] [PDF]
|
|