Impact of Glucagon-like peptide 1 receptor agonists on peripheral arterial disease in people with diabetes mellitus: A narrative review |
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| Affiliation: | 1. Centre for Diabetes and Endocrinology, Royal Berkshire NHS Foundation Trust, Reading, England, UK;2. First Department of Propaedeutic Internal Medicine and Diabetes Center, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece;1. Exercise Biochemistry Laboratory, School of Kinesiology, Western University, London, ON, Canada;2. Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada;3. Department of Physiology and Pharmacology, Schulich School of Medicine, Western University, London, ON, Canada;1. Metabolic Institute of America, Tarzana, CA, USA;2. Baylor Scott and White Research Institute, Baylor Scott and White Health, Dallas, TX, USA;3. University of Mississippi Medical Center, Jackson, MS, USA;4. American Heart Association Comprehensive Hypertension Center, University of Chicago Pritzker School of Medicine, Chicago, IL, USA;5. University of Texas Health Science Center at San Antonio, Texas Diabetes Institute, San Antonio, TX, USA;6. Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, UCLA Preventative Cardiology Program, UCLA Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;7. Division of Endocrinology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA;8. Grunberger Diabetes Institute, Internal Medicine and Molecular Medicine & Genetics, Wayne State University School of Medicine, Department of Internal Medicine, Oakland University William Beaumont School of Medicine, Bloomfield Hills, MI, USA;9. Department of Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic;10. Cardiology Division, Harvard Medical School, Massachusetts General Hospital, Cardiometabolic Trials, Baim Institute, Boston, MA, USA;11. Washington University School of Medicine, Saint Louis, MO, USA;12. Sansum Diabetes Research Institute, Santa Barbara, CA, USA;13. University of California Medical Center, Kushner Wellness Center, Long Beach, CA, USA;14. University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, TX, USA;15. Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA;p. Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA;q. Advanced Internal Medicine Group, PC, East Hills, NY, USA;r. AdventHealth Translational Research Institute, Orlando, FL, USA;s. Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA;t. Department of Medicine, Duke University Medical Center, Durham, NC, USA;u. Section of Endocrinology, Tulane University Health Sciences Center, New Orleans, LA, USA;1. Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC 27710, United States;2. Department of Medicine, Division of Endocrinology, Duke University Medical Center, Rd, Durham, NC 27710, United States;3. Department of Population Health Sciences, Duke University, Durham, NC 27710, United States;4. Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, 2301 Erwin Rd, Durham, NC 27710, United States;5. School of Nursing, Duke University, Durham, NC 27710, United States;1. Department of Cardiovascular Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou 510120, China;2. Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Gungzhou 510120, China;3. Guangzhou Key Laboratory of Molecular Mechanism and Translation in Major Cardiovascular Disease, Guangzhou 510120, China;4. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China;5. Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou 510120, China;1. MGH Neuroscience Center, Department of Neurology, Harvard Medical School, Boston, MA, United States of America;2. Department of Neurology, University of Colorado Hospital, Aurora, CD, United States of America;3. Department of Pathology, Massachusetts General Hospital, Boston, MA, United States of America;4. Division of Neuromuscular Research at Beth Israel Deaconess Medical Center, United States of America;5. Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland |
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| Abstract: | Peripheral arterial disease (PAD) is a common macrovascular complication of diabetes mellitus (DM). Glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1RAs) are among the latest class of antidiabetic medications that stimulate insulin synthesis and secretion and have been used for the management of type 2 DM. Apart from the effect on glycaemic control, GLP-1RAs also have a robust impact on weight reduction and have shown favorable effects on cardiovascular morbidity and mortality in cardiovascular outcome trials (CVOTs). The aim of this review was to examine the impact of GLP1-RAs on PAD among people with DM based on CVOTs, randomized controlled trials, observational studies as well as systematic reviews and meta-analyses. Data from retrospective studies and meta-analyses have shown superiority of these agents in comparison with other antidiabetic medications such as sodium-glucose cotransporter type 2 inhibitors and dipeptidyl peptidase-4 inhibitors in terms of PAD-related events. Nevertheless, data from CVOTs regarding the impact of GLP-1RAs on PAD are scarce and hence, safe conclusions regarding their effects cannot be drawn. Further prospective studies are needed to examine the impact of GLP-1RAs on PAD-related incidents including major adverse limb events, lower limb amputations and revascularization procedures. |
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