Dulaglutide and cardiovascular and heart failure outcomes in patients with and without heart failure: a post‐hoc analysis from the REWIND randomized trial. (20th September 2022)

• Record Type: Journal Article
• Authors: Branch, Kelley R.H.; Dagenais, Gilles R.; Avezum, Alvaro; Basile, Jan; Conget, Ignacio; Cushman, William C.; Jansky, Petr; Lakshmanan, Mark; Lanas, Fernando; Leiter, Lawrence A.; Pais, Prem; Pogosova, Nana; Raubenheimer, Peter J.; Ryden, Lars; Shaw, Jonathan E.; Sheu, Wayne H.H.; Temelkova‐Kurktschiev, Theodora; Bethel, M. Angelyn; Gerstein, Hertzel C.; Chinthanie, Ramasundarahettige; Probstfield, Jeffrey L.
• Is Part Of: European journal of heart failure. Volume 24:Number 10(2022)
• Page Start: 1805
• Page End: 1812
• Publication Date: 2022-09-20
• Subjects: Dulaglutide -- Glucagon‐like peptide 1 receptor agonist -- GLP‐1 -- Clinical trial -- Heart failure -- Major adverse cardiovascular events -- Heart failure hospitalization; Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1002/ejhf.2670
• Languages: English
• ISSNs: 1388-9842

Abstract

Abstract: Aims: People with diabetes are at high risk for cardiovascular events including heart failure (HF). We examined the effect of the glucagon‐like peptide 1 agonist dulaglutide on incident HF events and other cardiovascular outcomes in those with or without prior HF in the randomized placebo‐controlled Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial. Methods and results: The REWIND major adverse cardiovascular event (MACE) outcome was the first occurrence of a composite endpoint of non‐fatal myocardial infarction, non‐fatal stroke, or death from cardiovascular causes (including unknown causes). In this post‐hoc analysis, a HF event was defined as an adjudication‐confirmed hospitalization or urgent evaluation for HF. Of the 9901 participants studied over a median follow‐up of 5.4 years, 213/4949 (4.3%) randomly assigned to dulaglutide and 226/4952 (4.6%) participants assigned to placebo experienced a HF event (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.77–1.12; p = 0.456). In the 853 (8.6%) participants with HF at baseline, there was no change in either MACE or HF events with dulaglutide as compared to participants without HF ( p = 0.44 and 0.19 for interaction, respectively). Combined cardiovascular death and HF events were marginally reduced with dulaglutide compared to placebo (HR 0.88, 95% CI 0.78–1.00; p = 0.050) but unchanged in patients with and without HF at baseline ( p = 0.31). Conclusions: Dulaglutide was not associated with a reduction in HF events in patients with type 2 diabetes regardless of baseline HF status over 5.4 years of follow‐up.