Repository logo
 

The role of Glucagon-Like Peptide 1 Loading on periprocedural myocardial infarction During elective PCI (GOLD-PCI study): A randomized, placebo-controlled trial

Accepted version
Peer-reviewed

No Thumbnail Available

Type

Article

Change log

Authors

Giblett, Joel P 
Clarke, Sophie 
Zhao, Tian 
McCormick, Liam M 
Braganza, Denise M 

Abstract

BACKGROUND The incretin hormone glucagon-like peptide 1 (GLP-1) has been shown to protect against lethal ischemia-reperfusion injury in animal models and against nonlethal ischemia reperfusion injury in humans. Furthermore, GLP-1 receptor agonists have been shown to reduce major adverse cardiovascular and cerebrovascular events (MACCE) in large-scale studies. We sought to investigate whether GLP-1 reduced percutaneous coronary intervention (PCI)–associated myocardial infarction (PMI) during elective PCI.

METHODS The study was a randomized, double-blind controlled trial in which patients undergoing elective PCI received an intravenous infusion of either GLP-1 at 1.2 pmol/kg/min or matched 0.9% saline placebo before and during the procedure. Randomization was performed in 1:1 fashion, with stratification for diabetes mellitus. Six-hour cardiac troponin I (cTnI) was measured with a primary end point of PMI defined as rise ≫×5 upper limit of normal (280 ng/L). Secondary end points included cTnI rise and MACCE at 12 months.

RESULTS A total of 192 patients were randomized with 152 (79%) male and a mean age of 68.1 ± 8.9 years. No significant differences in patient demographics were noted between the groups. There was no difference in the rate of PMI between GLP-1 and placebo (9 [9.8%] vs 8 [8.3%], P = 1.0) or in the secondary end points of difference in median cTnI between groups (9.5 [0-88.5] vs 20 [0-58.5] ng/L, P = .25) and MACCE at 12 months (7 [7.3%] vs 9 [9.4%], P = .61).

CONCLUSIONS In this randomized, placebo-controlled trial, GLP-1 did not reduce the low incidence of PMI or abrogate biomarker rise during elective PCI, nor did it influence the 12-month MACCE rate which also remained low.

Description

Keywords

Aged, Biomarkers, Coronary Angiography, Dose-Response Relationship, Drug, Double-Blind Method, Elective Surgical Procedures, Female, Follow-Up Studies, Glucagon-Like Peptide 1, Humans, Infusions, Intravenous, Male, Myocardial Infarction, Myocardial Reperfusion Injury, Peptide Fragments, Percutaneous Coronary Intervention, Preoperative Period, Retrospective Studies, Treatment Outcome, Troponin I

Journal Title

American Heart Journal

Conference Name

Journal ISSN

0002-8703
1097-6744

Volume Title

215

Publisher

Elsevier BV
Sponsorship
MRC (unknown)
MRC (unknown)
Biometrika Trust (unknown)