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The effect of GLP-1 receptor agonists on N-terminal pro-brain natriuretic peptide. A scoping review and metanalysis

Angelo Avogaro1, Danila Azzolina2, Dario Gregori2

  • 1Department of Medicine, University of Padova, Italy.

International Journal of Cardiology
|March 20, 2022
PubMed

Insights

Glucagon-like peptide 1 receptor agonists (GLP-1RA) significantly reduce N-terminal pro-BNP levels, a marker of heart strain. This beneficial effect on heart health was consistent across various patient demographics and metabolic conditions.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Glucagon-like peptide 1 receptor agonists (GLP-1RA) are known to reduce major adverse cardiovascular events.
  • The impact of GLP-1RA on heart failure hospitalization risk appears limited, despite cardiometabolic benefits like weight reduction.
  • N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) is a key biomarker for cardiac stress and heart failure.

Purpose of the Study:

  • To evaluate the effect of GLP-1RA on N-terminal pro-BNP (NT-proBNP) levels through a meta-analysis.
  • To determine if GLP-1RA treatment influences NT-proBNP concentrations compared to placebo.
  • To investigate potential modifying factors on the NT-proBNP response to GLP-1RA therapy.

Main Methods:

  • A systematic meta-analysis of randomized controlled trials comparing GLP-1RA with placebo.
  • Inclusion criteria required reporting of NT-proBNP concentrations at baseline and end-of-treatment.
  • Nine trials involving 543 patients on active treatment and 536 on placebo were analyzed.

Main Results:

  • GLP-1RA treatment resulted in significantly greater reductions in NT-proBNP compared to placebo (standardized mean difference -0.14; 95% CI -0.27 to -0.01; p=0.03).
  • Meta-regression analysis indicated no significant modifying effect of age, HbA1c, or body mass index on NT-proBNP changes.
  • No significant meta-correlation was found between changes in NT-proBNP and changes in HbA1c or body weight.

Conclusions:

  • GLP-1RA therapy effectively reduces NT-proBNP levels.
  • The observed reduction in NT-proBNP by GLP-1RA is independent of patient age, baseline body weight, and glycemic control (HbA1c).
  • These findings suggest a direct beneficial effect of GLP-1RA on cardiac strain, irrespective of weight loss or metabolic improvements.
Abstract

Keywords:
Diabetes mellitusGlucagon-like peptide 1 receptor agonistsHeart failureNT-proBNP concentrations

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