Glucagon-like peptide-1 receptor agonist reduces recurrent cardiovascular risk in overweight/obese patients with type 2 diabetes mellitus complicated with coronary heart disease

Objective To explore the effect of glucagon-like peptide-1 receptor agonist (GLP-1RA) on cardiovascular risk in overweight/obese type 2 diabetic patients complicated with coronary heart disease. Methods A retrospective study was proceeded in 200 overweight/obese diabetic patients with coronary heart disease at Fuwai Hospital from October 2010 to October 2016. Patients were divided into GLP-1RA treatment group (n=105) and the conventional treatment group (n=95). Data of body weight,body mass index (BMI), glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG) and blood lipids before and after treatment for 6 months or drug withdrawal after 30 months were analyzed. The incidence rates of recurrent cardiovascular events/the cardiovascular risks were also evaluated between these 2 groups. Kruskal-Wallis test was used to compare the continuous variables in non-normal distribution, Student-t test was used to compare the continuous variables in normal distribution,and paired t-test was used to analyze the follow-up data and baseline data. Chi-Square test was used to compare the classified variable between groups. Multivariate Logistic regression analysis was used to analyze the related risk factors of cardiovascular events. Results Weight [(-5.7±4.0) vs (-1.3±2.4)kg], BMI [(-1.9±1.3) vs (-0.4±0.7)kg/m2], HbA1c [(-1.5±1.3)% vs (-0.8±0.6)%] and low density lipoprotein cholesterol after 6-month treatment were significantly decreased in GLP-1RA treatment group than those in conventional treatment group (t=2.42-4.19, all P<0.05). After 30-month following-up, the incidence rates of cardiovascular events in GLP-1RA group were significantly lower than those in conventional treatment group [2.86%(3/105) vs 11.58%(11/95), χ2=4.57, P<0.05]. Compared with conventional treatment group after adjustment of multiple risk factors, the risk of recurrent cardiovascular events in GLP-1RA treatment group was significantly decreased (OR:0.23, 95%CI: 0.06-0.89, P=0.04). Conclusion Short-term application of GLP-1RA could alleviate body weight, improve glycolipid metabolic disorder, and reduce the risk of recurrent cardiovascular events in overweight/obese type 2 diabetic patients with coronary heart disease. Key words: Diabetes mellitus, type 2; Overweight; Obesity; Coronary artery disease; Cardiovascular risk; Glucagon-like peptide-1 receptor agonist