Effects of Liraglutide on Cardiovascular Events in Hypoglycemia

Investigators examined the association between hypoglycemia and cardiovascular outcomes and death.

Findings of the Liraglutide Effect and Action in Evaluation of Cardiovascular Outcome Results (LEADER) cardiovascular outcomes trial showed that patients with type 2 diabetes who experienced an extreme hypoglycemic event had an elevated risk for a cardiovascular event or a cardiovascular-related death, according to a study published in Diabetes Care.

In the LEADER study, patients were randomly assigned into an experiment arm that received liraglutide (n=4668) or into a control arm that received a placebo medication (n=4672) and monitored for the next 3.5 to 5 years for hypoglycemic and major adverse cardiovascular events

Hypoglycemic events were self-reported and severe hypoglycemia required another person’s aid in a resuscitative action. The liraglutide arm had a major adverse cardiovascular event occur in 13% of the patients, and the placebo arm had an occurrence in 15% of patients. The liraglutide arm showed significantly fewer hypoglycemic events than the placebo arm. Overall, patients who had a severe hypoglycemic event had a significant increase in the chance of a major adverse cardiovascular event, cardiovascular death, and all-cause death. The data also show that these cardiovascular events occur a short time after the severe hypoglycemic event.

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These results point to a clinical need to monitor patients closely after a severe hypoglycemic event for symptoms of a cardiovascular event. The researchers noted, “the cardioprotective effects of liraglutide appearing largely independent of reductions in hypoglycemia, minimize[ed] the risk of hypoglycemia.”

This study was supported by Novo Nordisk A/S. Please refer to reference for a complete list of authors’ disclosures.


Zinman B, Marso SP, Christiansen E, Calanna S, Rasmussen S, Buse JB; for the LEADER Publication Committee on behalf of the LEADER Trial Investigators. Hypoglycemia, cardiovascular outcomes, and death: The LEADER experience [published online June 14, 2018]. Diabetes Care. doi: 10.2337/dc17-2677

This article originally appeared on Endocrinology Advisor