Liraglutide suitable for T2D patients regardless of heart failure history

The glucagon-like peptide-1 receptor agonist liraglutide has been shown to be safe in patients with type 2 diabetes (T2D) with or without a history of New York Heart Association (NYHA) functional class I to III heart failure (HF), according to a study.

A total of 9,340 patients with T2D and high cardiovascular risk were randomized 1:1 to liraglutide (1.8 mg daily or maximum tolerated dose up to 1.8 mg daily) or placebo plus standard care and were followed for 3.5–5 years. Those with NYHA functional class IV HF were excluded.

Time to first occurrence of cardiovascular death, nonfatal myocardial infarction or nonfatal stroke was the primary outcome. Posthoc Cox regression analyses of these outcomes by baseline HF history were performed.

Of the patients, 18 percent had a history of NYHA functional class I to III HF (liraglutide: n=835 of 4,668; placebo: n=832 of 4,672) at baseline. Liraglutide, compared with placebo, showed consistent effects on major adverse cardiovascular events in patients with (hazard ratio [HR], 0.81, 95 percent confidence interval [CI], 0.65–1.02) and without (HR, 0.88, 95 percent CI, 0.78–1.00) a history of HR (p_interaction=0.53).

Both subgroups reported fewer death with liraglutide (with HF: HR, 0.89, 95 percent CI, 0.70–1.14; without HF: HR, 0.83, 95 percent CI, 0.70–0.97; p_interaction=0.63) compared with placebo. There was also no increased risk of HF hospitalization with liraglutide, regardless of HF history (with HF: HR, 0.98, 95 percent CI, 0.75–1.28; without HF: HR, 0.78, 95 percent CI, 0.61–1.00; p_interaction=0.22).

In addition, liraglutide showed consistent effects on the composite of HF hospitalization or cardiovascular death in patients with (HR, 0.92, 95 percent CI, 0.74–1.15) and without (HR, 0.77, 95 percent CI, 0.65–0.91) a history of HF (p_interaction=0.19).