Cardiovascular effects of GLP-1 and GLP-1-based therapies: implications for the cardiovascular continuum in diabetes?

• Published in: Diabetic medicine 2013-03, Vol.30 (3), p.289-299
• Main Authors: Burgmaier, M., Heinrich, C., Marx, N.
• Format: Article
• Language: English
• Subjects: Animals; Atherosclerosis - etiology; Biological and medical sciences; Clinical Trials as Topic; Diabetes; Diabetes Mellitus, Type 2 - drug therapy; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - drug therapy; Diabetic Angiopathies - etiology; Diabetic Cardiomyopathies - drug therapy; Diabetic Cardiomyopathies - etiology; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; Dogs; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Endothelium, Vascular - physiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; Glucagon-Like Peptide 1 - physiology; Glucagon-Like Peptide-1 Receptor; Heart Failure - drug therapy; Humans; Hypoglycemic Agents - therapeutic use; Medical sciences; Mice; Myocardium - metabolism; Obesity - complications; Peptides; Rats; Receptors, Glucagon - antagonists & inhibitors; Risk Factors; Swine; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2012.03746.x

Diabet. Med. 30, 289–299 (2013) Aims  Glucagon‐like peptide‐1 receptor agonists and inhibitors of dipeptidyl peptidase‐4 that increase glucagon‐like peptide‐1 plasma concentrations are current treatment options for patients with diabetes mellitus. As patients with diabetes are a high‐risk population for the development of a severe and diffuse atherosclerosis, we aim to review the potential action of these drugs on cardiovascular disease and to summarize the potential role of present glucagon‐like peptide‐1‐based therapies from a cardiologist’s point of view. Methods  Using a PubMed/MEDLINE search without language restriction, studies were identified and evaluated in order to review the effects of glucagon‐like peptide‐1‐based therapy on different stages of the cardiovascular continuum. Results  Recent experimental as well as clinical data suggest that dipeptidyl peptidase‐4 inhibitors and glucagon‐like peptide‐1 receptor agonists—in addition to their metabolic effects—may have beneficial effects on the cardiovascular continuum at multiple stages, including: (1) cardiovascular risk factors; (2) molecular mechanisms involved in atherogenesis; (3) ischaemic heart disease; and (4) heart failure. Furthermore, retrospective analysis suggested decreased cardiovascular events in patients with glucagon‐like peptide‐1‐based therapies. Conclusion  There are ample data to suggest beneficial effects of glucagon‐like peptide‐1‐based therapies on the cardiovascular continuum and large‐scale clinical trials are warranted to determine whether these effects translate into improved cardiovascular endpoints in humans.