Student's Journal of Health Research Africa (Dec 2023)
ASSESSING THE LEADER TRIAL: UNDERSTANDING MYOCARDIAL INFARCTION SUBTYPES IN TYPE 2 DIABETES MELLITUS PATIENTS AND THE BENEFICIAL IMPACT OF LIRAGLUTIDE THERAPY.
Abstract
Background: Myocardial infarction (MI), often associated with diabetes mellitus (DM), lacks detailed subtype data. Liraglutide, administered to high-risk Type 2 DM individuals, reduced major CV events, including CV mortality, non-fatal MI, and non-fatal stroke, based on the LEADER trial (8,240 participants). It notably lowered MI risk (192 liraglutide vs. 239 placebo). This post-hoc analysis examines MI differences, outcomes, subtypes, and troponin levels in LEADER. Methods: LEADER trial data were used to assess MI occurrences in the liraglutide and placebo groups, considering MI subtype, troponin levels, and baseline patient characteristics. Results: Reports of 680 MIs (both first and recurrent) were made; the liraglutide group had fewer than the placebo group (259 vs. 321). With liraglutide, the number of MIs linked to CV death was significantly reduced (7 vs. 18 fatal MIs). The majority of MIs with symptoms were spontaneous MIs (418/541) and non-ST-segment elevation MIs (455/541). Baseline data displayed that a greater proportion of MI individuals treated with liraglutide had previously undergone a coronary artery bypass graft, whereas a smaller proportion had peripheral arterial disease in the lower limbs and more than 50% stenosis in different arteries (coronary, carotid, etc.). Conclusion: According to this investigation, liraglutide may affect the clinical results of MI and lower the incidence of myocardial infarction in high-risk type 2 DM patients. Recommendation: This study supports considering liraglutide therapy for high-risk Type 2 diabetes mellitus patients, especially those with a history of cardiovascular issues or heightened MI risk. Healthcare providers should assess patient risk factors and discuss liraglutide's potential benefits in reducing MI and related major adverse cardiovascular events. Regular troponin level monitoring and MI subtype evaluation can guide personalized treatment. Ongoing research may offer further insights into liraglutide's long-term impact on MI outcomes in Type 2 DM patients.
Keywords
