Certain Diabetes Medications May Lower Heart Failure Risk
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Researchers from Henry Ford Hospital in Detroit found that patients taking so-called GLP-1 drugs -- including brand-name medications such as Byetta, Januvia and Victoza -- were more than 40 percent less likely to be hospitalized for heart failure than patients prescribed other blood sugar-lowering medications. GLP-1 diabetes drugs have been in use for only the last several years and are considered second-line treatments after well-established medications such as metformin, physicians said.
"I don't think we can say this will magically prevent all heart failure deaths, but the strength of the association warrants more investigation," said study author and cardiologist Dr. David Lanfear. "Heart failure is a very common disease . . . but something about diabetics make them definitely at increased risk for developing heart failure."
The study is to be presented Sunday at the American College of Cardiology's annual meeting in San Francisco. Evidence presented at medical meetings has not been peer-reviewed and is considered preliminary.
According to the U.S. National Institutes of Health, about 6 million Americans suffer from heart failure, which occurs when the heart can't efficiently pump blood through the body. Diabetics, who now number 25 million in the United States, are between two and four times more likely than those without the condition to die of heart disease, which includes heart attacks, heart failure and other cardiac problems.
In the retrospective study, Lanfear and his colleagues examined data from more than 4,400 patients taking diabetes medications between 2000 and 2012. About 1,500 were taking GLP-1 medications and nearly 3,000 were not.
Over an average nine-month follow-up period, patients taking GLP-1 medications were 41 percent less likely than others to be hospitalized with heart failure. Additionally, these patients were 44 percent less likely to be hospitalized for any reason, and 80 percent less likely to die of any cause.
But neither Lanfear nor a doctor not involved with the research could point to reasons why this newer class of diabetes drugs seems to dampen the risk of heart failure.
"We don't know the mechanism yet. It's under active investigation," Lanfear said. "There are clues, but they would be a guess."
Lanfear noted that of the total 20,000 patients at Henry Ford Hospital identified as taking diabetes drugs during the study period, only about 1,500 were taking GLP-1 medications, or about 7 percent.
"We were surprised a little bit by the strength of the association [between the GLP-1 drugs and lower heart failure], but the results still need to be confirmed by other studies," he said. "We can't take this as an endorsement of these drugs."
Calling the study promising, Dr. David Friedman, chief of heart failure services at North Shore-LIJ's Plainview Hospital in Plainview, N.Y., said future research should be prospective instead of analyzing past data.
"Heart failure is a huge problem among diabetics. Every year, there are about a half-million new heart failure patients, and a tremendous portion are those who've survived heart attacks and a fair number have diabetes," Friedman said.
"With diabetes and obesity issues constantly on the radar now, and with the onset of more heart failure cases, we need to find more novel approaches," he added. "If we can improve outcomes in this way, we'll have more hope for these patients."
SOURCES: David Lanfear, M.D., cardiologist and researcher, Henry Ford Hospital, Detroit; David Friedman, M.D., chief, heart failure services, North Shore LIJ's Plainview Hospital, Plainview, N.Y.; March 10, 2013, presentation, American College of Cardiology annual meeting, San Francisco