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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Incretin therapy and heart failure
1Departments of Advanced Cardiology, Saga University Faculty of Medicine.
Abstract:
Type 2 diabetes mellitus (T2DM) is widely prevalent and a critical risk factor for cardiovascular disease that increases both morbidity and mortality. Recently, new therapies based on the actions of the incretin hormones have become widely used, offering advantages over conventional treatments by limiting hypoglycemia and achieving glycemic control. Moreover, many experimental studies have suggested that GLP-1 and related drugs exert cardioprotective effects on atherosclerosis and cardiac dysfunction both in vitro and in vivo. However, there is thus far little clinical evidence supporting the efficacy of incretin therapy in patients with cardiovascular disease. This review focuses on the effects of GLP-1-related therapy on cardiac function from the bench to the bed, with a discussion of possible underlying mechanisms.
Insights
Incretin-based therapies, like glucagon-like peptide-1 (GLP-1) drugs, show promise for type 2 diabetes (T2DM) patients with cardiovascular disease. While experimental data suggest heart benefits, clinical evidence is still limited.
Area of Science:
- Endocrinology and Metabolism
- Cardiovascular Medicine
- Pharmacology
Background:
- Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease (CVD), contributing significantly to morbidity and mortality.
- Incretin-based therapies, targeting glucagon-like peptide-1 (GLP-1) and related pathways, offer improved glycemic control and reduced hypoglycemia risk compared to traditional T2DM treatments.
- Preclinical studies indicate potential cardioprotective effects of GLP-1 and its analogs against atherosclerosis and cardiac dysfunction.
Purpose of the Study:
- To review the current evidence on the impact of GLP-1-related therapies on cardiac function in patients with cardiovascular disease.
- To explore the potential mechanisms underlying the cardioprotective effects of incretin-based treatments.
- To bridge the gap between experimental findings ('bench') and clinical application ('bed') for GLP-1 therapy in CVD patients.
Main Methods:
- Comprehensive literature review of experimental (in vitro and in vivo) and clinical studies.
- Analysis of data focusing on the effects of GLP-1 and related drugs on cardiovascular outcomes and cardiac function.
- Discussion of proposed molecular and cellular mechanisms of action.
Main Results:
- Extensive experimental data support cardioprotective roles for GLP-1-related therapies in models of atherosclerosis and cardiac dysfunction.
- Clinical evidence demonstrating the efficacy of these therapies specifically in patients with established cardiovascular disease remains limited.
- GLP-1 receptor agonists and related agents have shown potential in improving glycemic control and offering cardiovascular benefits.
Conclusions:
- GLP-1-related therapies present a promising avenue for managing T2DM patients with comorbid cardiovascular conditions.
- Further robust clinical trials are essential to confirm the cardioprotective efficacy and establish the role of incretin therapy in this high-risk population.
- Understanding the underlying mechanisms is crucial for optimizing therapeutic strategies and patient selection.
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