Abstract 16047: Decreased Plasma Levels of Active Glucagon-Like Peptide-1 Correlate With Coronary Artery Disease and Coronary Plaque Complexity in High-Risk Patients
Background: Glucagon-like peptide-1 (GLP-1) plays an important role in pathogenesis of diabetes mellitus (DM). Involvement of GLP-1 in cardiovascular diseases remains unclear. We investigate the association between plasma levels of active GLP-1 (aGLP-1) and coronary artery disease (CAD) and coronary plaque complexity.
Methods and Results: At fasting state or during 75g-oral glucose tolerance test (OGTT), we measured plasma levels of aGLP-1 from peripheral vein in 306 consecutive, stable, high-risk patients [67±10 years, 61% men, 177 (58%) CAD], including 57 overt type-2 DM. 75g-OGTT identified patients with newly diagnosed DM (n=29). We also assessed coronary plaque complexity by using Syntax score in CAD patients. Fasting aGLP-1 were undetected (<2.0 pmol/L) in more patients with CAD than non-CAD patients [43 (24%) vs.15 (12%), P<0.01]. Fasting aGLP-1 levels were significantly lower in CAD patients than non-CAD patients (3.2 [2.5-4.0] vs. 3.7 [2.7-5.0] pmol/L, p<0.01). The aGLP-1 levels during OGTT were lasting significantly lower in CAD patients than non-CAD patients (60 min; 5.8 [3.8-9.3] vs.7.6 [5.1-13.5], 120 min; 4.9 [3.1-8.2] vs.6.3 [4.1-9.4] pmol/L, p=0.01, respectively). Stepwise backward multivariate logistic regression analysis including the presence of DM, HbA1c, and fasting insulin identified the fasting aGLP-1 levels [odds ratio (OR); 0.82, 95%-confidence interval (CI) 0.70-0.94, p<0.01] as an independent variable associated with the presence of CAD in high-risk patients. Fasting aGLP-1 levels were significantly lower in patients with severe coronary plaque complexity (Syntax score≥33, n=27) than mild to moderate coronary plaque complexity (Syntax score<33, n=107) (2.9 [2.3-3.3] vs.3.2 [2.5-4.2] pmol/L, p<0.05). Stepwise backward multivariate logistic regression analysis demonstrated that the fasting aGLP-1 levels (OR; 0.57, 95%- CI; 0.34-0.97, p<0.05) were independently associated with the presence of severe coronary plaque complexity in CAD patients.
Conclusions: Plasma levels of aGLP-1 at fasting state or during 75g-OGTT were significantly reduced in CAD patients and lower levels of aGLP-1 significantly correlated with coronary plaque complexity. GLP-1 might play a crucial role in the pathogenesis of CAD.
- © 2011 by American Heart Association, Inc.