Effect of continuous exenatide infusion on cardiac function and peri-operative glucose control in patients undergoing cardiac surgery: A single-blind, randomized controlled trial
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Randomized Controlled Trial
PubMed
28581209
DOI
10.1111/dom.13029
Knihovny.cz E-resources
- Keywords
- cardiac surgery, exenatide, heart function, peri-operative glucose control,
- MeSH
- Glucagon-Like Peptide-1 Receptor Agonists MeSH
- Ventricular Dysfunction, Left blood surgery MeSH
- Exenatide MeSH
- Hyperglycemia blood epidemiology prevention & control MeSH
- Hypoglycemia blood chemically induced epidemiology prevention & control MeSH
- Hypoglycemic Agents administration & dosage adverse effects therapeutic use MeSH
- Incidence MeSH
- Incretins administration & dosage adverse effects therapeutic use MeSH
- Infusions, Intravenous MeSH
- Insulin administration & dosage adverse effects therapeutic use MeSH
- Single-Blind Method MeSH
- Cardiotonic Agents administration & dosage adverse effects therapeutic use MeSH
- Drug Therapy, Combination adverse effects MeSH
- Coronary Artery Bypass adverse effects MeSH
- Humans MeSH
- Hospitals, University MeSH
- Proof of Concept Study MeSH
- Peptides administration & dosage adverse effects therapeutic use MeSH
- Perioperative Care adverse effects MeSH
- Intraoperative Complications blood chemically induced epidemiology prevention & control MeSH
- Postoperative Complications blood chemically induced epidemiology prevention & control MeSH
- Glucagon-Like Peptide-1 Receptor metabolism MeSH
- Risk MeSH
- Aged MeSH
- Heart drug effects physiopathology MeSH
- Venoms administration & dosage adverse effects therapeutic use MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Czech Republic epidemiology MeSH
- Names of Substances
- Glucagon-Like Peptide-1 Receptor Agonists MeSH
- Exenatide MeSH
- Hypoglycemic Agents MeSH
- Incretins MeSH
- Insulin MeSH
- Cardiotonic Agents MeSH
- Peptides MeSH
- Glucagon-Like Peptide-1 Receptor MeSH
- Venoms MeSH
We performed a randomized controlled trial with the glucagon-like peptide-1 (GLP-1) receptor agonist exenatide as add-on to standard peri-operative insulin therapy in patients undergoing elective cardiac surgery. The aims of the study were to intensify peri-operative glucose control while minimizing the risk of hypoglycaemia and to evaluate the suggested cardioprotective effects of GLP-1-based treatments. A total of 38 patients with decreased left ventricular systolic function (ejection fraction ≤50%) scheduled for elective coronary artery bypass grafting (CABG) were randomized to receive either exenatide or placebo in a continuous 72-hour intravenous (i.v.) infusion on top of standard peri-operative insulin therapy. While no significant difference in postoperative echocardiographic variables was found between the groups, participants receiving exenatide showed improved peri-operative glucose control as compared with the placebo group (average glycaemia 6.4 ± 0.5 vs 7.3 ± 0.8 mmol/L; P < .001; percentage of time in target range of 4.5-6.5 mmol/L 54.8% ± 14.5% vs 38.6% ± 14.4%; P = .001; percentage of time above target range 39.7% ± 13.9% vs 52.8% ± 15.2%; P = .009) without an increased risk of hypoglycaemia (glycaemia <3.3 mmol/L: 0.10 ± 0.32 vs 0.21 ± 0.42 episodes per participant; P = .586). Continuous administration of i.v. exenatide in patients undergoing elective CABG could provide a safe option for intensifying the peri-operative glucose management of such patients.
References provided by Crossref.org
ClinicalTrials.gov
NCT01373216
