Effects of albiglutide on myocardial infarction and ischemic heart disease outcomes in patients with type 2 diabetes and cardiovascular disease in the Harmony Outcomes trial.

AIMS:Large outcome trials have demonstrated cardiovascular benefits of selected glucagon-like peptide-1 (GLP-1) receptor agonists. We examined coronary disease outcomes in the Harmony Outcomes trial of the GLP-1 receptor agonist albiglutide. METHODS AND RESULTS:Harmony Outcomes was an event-driven, multicenter, double-blind, placebo-controlled trial involving 9 463 patients > 40years of age with type-2 diabetes and established atherosclerotic cardiovascular disease. It tested the effects of albiglutide on the occurrence of a composite primary endpoint, consisting of cardiovascular death, myocardial infarction or stroke. Within this post-hoc analysis, the effects of albiglutide on myocardial infarction subtypes and other ischemic endpoints were analyzed.During the median-follow up of 1.6 years, a total of 421 patients (4.5%) experienced at least one myocardial infarction, with 72 patients having more than one event. Treatment with albiglutide reduced both first events (hazard ratio (HR)0.75 (0.62-0.91)) and overall events (HR0.75 (0.61-0.91)) as well as first type 1 (HR0.73 (0.57-0.92)) and type 2 myocardial infarctions (HR0.65 (0.46-0.92)). The effect of albiglutide treatment was consistent for ST-segment elevation (HR0.69 (0.38-1.26)) and non-ST elevation (HR0.86 (0.66-1.2) myocardial infarction. CONCLUSIONS:Treatment with the GLP-1 receptor agonist albiglutide resulted in a 25% relative risk reduction in myocardial infarction that was consistent for type of infarction and presence or absence of ST elevation. Our findings add novel information about the effects of GLP-1 receptor agonists on ischemic events in patients with type 2 diabetes.