GLP-1 levels may predict cardiovascular risk in heart attack

Germany: The levels of glucagon-like peptide 1 (GLP-1) can predict cardiovascular risk in patients with acute myocardial infarction (heart attack), suggests a recent study published in the European Heart Journal.

GLP-1 is a gut incretin hormone that induces post-prandial insulin secretion. The levels of GLP-1 were recently found to be at elevated levels in patients with acute myocardial infarction (MI). Glucagon-like peptide 1 receptor agonists improve cardiovascular outcomes in patients with diabetes.

Florian Kahles, University Hospital Aachen, Aachen, Germany, and colleagues aimed to assess the predictive capacity of GLP-1 serum levels for cardiovascular outcome in patients with myocardial infarction.

The researchers assessed total GLP-1, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the Global Registry of Acute Coronary Events (GRACE) score in 918 patients presenting with myocardial infarction [321 ST-segment elevation myocardial infarction and 597 non-ST-segment elevation myocardial infarction (NSTEMI)] at the time of hospital admission.

The primary composite outcome of the study was the first occurrence of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke.

Key findings of the study include:

• Kaplan–Meier survival plots and univariable Cox regression analyses found GLP-1 to be associated with adverse outcome [hazard ratio (HR) of logarithmized GLP-1 values: 6.29).


• After further adjustment for age, sex, family history of cardiovascular disease, smoking, diabetes, hypertension, hypercholesterinaemia, glomerular filtration rate (GFR) CKD-EPI, hs-CRP, hs-Troponin T, and NT-proBNP levels the HR remained significant at 10.98).


• Time-dependent receiver operating characteristic curve analyses illustrated that GLP-1 levels are a strong indicator for early events.


• For events up to 30 days after admission, GLP-1 proved to be superior to other biomarkers including hs-Troponin T, GFR CKD-EPI, hs-CRP, and NT-proBNP.


• Adjustment of the GRACE risk estimate by addition of GLP-1 increased the area under the receiver operating characteristic curve over time in NSTEMI patients.

"These results demonstrate that GLP-1 levels are significantly associated with cardiovascular events in patients hospitalized for myocardial infarction," concluded the authors.

More Information: "Glucagon-like peptide 1 levels predict cardiovascular risk in patients with acute myocardial infarction" published in the European Heart Journal.

DOI: https://doi.org/10.1093/eurheartj/ehz728

Journal Information: European Heart Journal