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利拉鲁肽治疗心力衰竭:FIGHT 和 LIVE 的观察。

Liraglutide in the treatment of heart failure: insight from FIGHT and LIVE.

机构信息

Nanjing University of Chinese Medicine, Nanjing, China.

Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Cardiovasc Diabetol. 2020 Jul 6;19(1):106. doi: 10.1186/s12933-020-01088-3.

Abstract

There are many glucose-lowering agents used in patients with heart failure, showing mixed results, this study was conducted to determine the effect of liraglutide, a glucagon-like peptide-1 analogue, on the treatment of patients with heart failure. Patients from the FIGHT and LIVE trials were included, all overlapped data were summarized and described. No significant changes from baseline in left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, hemoglobin A1c, heart rate, left ventricular end-systolic volume index, left ventricular end-diastolic volume index, and 6 min walk test were observed in FIGHT. In LIVE, liraglutide significantly decreased hemoglobin A1c and inceased 6 min walk test and increased heart rate and serious cardiac adverse events, and there were no statistical differences in left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, left ventricular end-systolic volume index, and left ventricular end-diastolic volume index. In this study, we found that there is not enough reason to support the use of liraglutide in patients with heart failure, and importantly, the safety of liraglutide in this particular population remains uncertain. Enhanced recognition the risks and benefits of liraglutide would help guide therapeutic decisions in patients with heart failure.

摘要

有许多用于心力衰竭患者的降糖药物,但结果喜忧参半。本研究旨在确定胰高血糖素样肽-1 类似物利拉鲁肽对心力衰竭患者治疗的效果。FIGHT 和 LIVE 试验的患者均被纳入研究,对所有重叠数据进行总结和描述。FIGHT 试验中,未观察到利拉鲁肽治疗后左心室射血分数、N 末端脑钠肽前体、糖化血红蛋白、心率、左心室收缩末期容积指数、左心室舒张末期容积指数和 6 分钟步行试验有显著变化。而在 LIVE 试验中,利拉鲁肽显著降低了糖化血红蛋白,增加了 6 分钟步行试验和心率,增加了严重心脏不良事件,左心室射血分数、N 末端脑钠肽前体、左心室收缩末期容积指数和左心室舒张末期容积指数无统计学差异。本研究发现,尚无充分理由支持心力衰竭患者使用利拉鲁肽,更重要的是,利拉鲁肽在这一特定人群中的安全性仍不确定。提高对利拉鲁肽风险和获益的认识将有助于指导心力衰竭患者的治疗决策。

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