Albiglutide and atrial fibrillation in patients with type 2 diabetes and established cardiovascular disease - insights from the Harmony Outcomes trial.

Autor:	Krychtiuk KA; Duke Clinical Research Institute, Durham, NC, USA., Marquis-Gravel G; Duke Clinical Research Institute, Durham, NC, USA., Murphy S; Duke Clinical Research Institute, Durham, NC, USA., Chiswell K; Duke Clinical Research Institute, Durham, NC, USA., Green JB; Duke Clinical Research Institute, Durham, NC, USA., Leiter LA; Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada., Lopes RD; Duke Clinical Research Institute, Durham, NC, USA., Del Prato S; Section on Diabetes, Department of Clinical and Experimental Medicine, University of Pisa, and Sant'Anna School of Advanced Studies, Pisa, Italy., McMurray JJV; British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK., Hernandez AF; Duke Clinical Research Institute, Durham, NC, USA., Granger CB; Duke Clinical Research Institute, Durham, NC, USA.
Jazyk:	angličtina
Zdroj:	European journal of preventive cardiology [Eur J Prev Cardiol] 2024 Nov 27. Date of Electronic Publication: 2024 Nov 27.
DOI:	10.1093/eurjpc/zwae379
Abstrakt:	Introduction: Atrial fibrillation and flutter (AF) are common in patients with type 2 diabetes and are associated with worse outcomes. Methods: Harmony Outcomes was a multicenter, event-driven, double-blind, placebo-controlled trial comparing the effects of albiglutide, a glucagon-like peptide-1 (GLP1) receptor agonist, with placebo on a composite of major adverse cardiac events (MACE; non-fatal myocardial infarction; non-fatal stroke and cardiovascular death) in 9,463 patients aged >40years with type-2 diabetes and established cardiovascular disease. Herein, the cardiovascular effects of albiglutide in patients with and without AF, as well as the effects on AF events during follow-up, were analyzed. Results: Patients with a history of AF (8.9%) exhibited a higher event rate for the primary composite MACE endpoint during 1.6 years of follow-up (12.7 vs. 6.3 events/100 person-years, adjusted hazard ratio (aHR)1.41 (95% Confidence Interval (CI)1.14-1.74, p=0.001). Treatment with albiglutide reduced the occurrence of the primary endpoint irrespective of history of AF at baseline (history of AF: aHR0.83 (0.58-1.19), no history of AF: aHR0.77 (0.66-0.90); pinteraction=0.71). During follow-up, 239 patients (2.5%) experienced an AF event. Overall, Albiglutide was associated with numerically fewer AF events (108 vs 131; HR 0.82 (0.63-1.06, p=0.12), irrespective of baseline history of AF (pinteraction=0.92). Conclusions: In patients with type 2 diabetes, treatment with albiglutide, compared to placebo, reduced the risk of cardiovascular events irrespective of history of AF. Further, albiglutide treatment did not increase AF adverse events but was associated with a trend to a lower rate of AF events during follow-up without reaching statistical significance. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu