Cardiovascular effects of glucagonlike peptide-1 agonists

Type 2 diabetes mellitus is acknowledged as a major risk factor for the development of cardiovascular disease (CVD). Advancing treatment options for person with diabetes beyond glucose control to prevent microvascular and macrovascular complications and ultimately have an impact on CVD development holds great significance for the growing number of persons with diabetes. Glucagonlike peptide-1 (GLP-1) is an incretin secreted in response to nutrient ingestion that inhibits glucagon secretion and gastric emptying, resulting in reduced postprandial glycemia. GLP-1 has insulinomimetic, insulinotropic, and antiapoptotic properties. GLP-1 agonists (exenatide and liraglutide) are a class of drugs approved for the treatment of diabetes that have significant cardiovascular (CV) effects. These CV effects potentially provide an opportunity for clinicians to address the multifactorial issues involved in the increased CV morbidity and mortality associated with diabetes. This article presents an overview of the CV effects of GLP-1 agonists, highlighting implications for the management of patients with diabetes and heart disease.