Evidence map›GLP-1 receptor agonists × all-cause mortality›PMID 36082522›Full record

Trial reportDiabetes, obesity & metabolism2023

Risk of adverse events with liraglutide in heart failure with reduced ejection fraction: A post hoc analysis of the FIGHT trial.

João Sérgio Neves, Francisco Vasques-Nóvoa, Marta Borges-Canha, Ana Rita Leite, Abhinav Sharma, Davide Carvalho, Milton Packer, Faiez Zannad, Adelino Leite-Moreira, João Pedro Ferreira

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2023. The graph read 4 numbers from its abstract, feeding 1 cell of the map: it finds no clear difference in 1. It also reports an association that does not count as treatment evidence, such as IRR 1.86 (1.21 to 2.85) for all-cause mortality. Cited by 34 papers, 3 of them syntheses that pooled it.

4numbers the graph read from it
1cell of the map it votes in
34citing papers in PubMed, 3 pooled it
8.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
21 · no effect
All-cause mortalityno clear difference · against placebo · heart_failurefeeds one cell of the map
IRR 1.760.92 to 3.37P = 0.088
RESULTS: Compared to placebo, there was a trend towards increased risk with liraglutide of total HF hospitalizations or all-cause deaths (96 vs. 143 events, incidence rate ratio [IRR] 1.41, 95% confidence interval [CI] 0.98-2.04; P = 0.064) and total arrhythmias (21 vs. 39, IRR 1.76, 95% CI 0.92-3.37; P = 0.088).
FeedsGLP-1 receptor agonists×all-cause mortality
All-cause mortalityno clear difference · against placebo · heart_failurefeeds one cell of the map
IRR 1.410.98 to 2.04P = 0.064
RESULTS: Compared to placebo, there was a trend towards increased risk with liraglutide of total HF hospitalizations or all-cause deaths (96 vs. 143 events, incidence rate ratio [IRR] 1.41, 95% confidence interval [CI] 0.98-2.04; P = 0.064) and total arrhythmias (21 vs. 39, IRR 1.76, 95% CI 0.92-3.37; P = 0.088).
FeedsGLP-1 receptor agonists×all-cause mortality

Read, but not usablea number the graph found but could not read as for or against

All-cause mortalityan association or prognostic statement, not a treatment comparison · against placebo · heart_failurefeeds one cell of the map
IRR 1.861.21 to 2.85
The risk of HF hospitalizations or all-cause deaths with liraglutide was higher among patients in New York Heart Association (NYHA) Class III to IV (IRR 1.86, 95% CI 1.21-2.85) than in those in NYHA Class I to II (IRR 0.62, 95% CI 0.31-1.23; interaction P = 0.008), and among patients with diabetes (interaction P = 0.051).
FeedsGLP-1 receptor agonists×all-cause mortality
All-cause mortalityan association or prognostic statement, not a treatment comparison · against placebo · heart_failurefeeds one cell of the map
IRR 0.620.31 to 1.23P = 0.008
The risk of HF hospitalizations or all-cause deaths with liraglutide was higher among patients in New York Heart Association (NYHA) Class III to IV (IRR 1.86, 95% CI 1.21-2.85) than in those in NYHA Class I to II (IRR 0.62, 95% CI 0.31-1.23; interaction P = 0.008), and among patients with diabetes (interaction P = 0.051).
FeedsGLP-1 receptor agonists×all-cause mortality

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×all-cause mortality

InconclusiveOpen on the map →What to test next →

11 readable studies in this cell: 7 favour the treatment, 4 find no difference, 0 favour the comparator.

Belief with this paper
0.87replicated · 7 families support, 1 contradict · against placebo
Without it
0.88This paper does not move the number.
← favours the treatmentfavours the comparator →
1 · no effect
This paper · 2023
IRR 1.760.92 to 3.37
NCT0399313226,774 enrolled · 2018
HR 0.990.83 to 1.18
NCT0357459717,604 enrolled · 2018
HR 0.800.72 to 0.89
NCT013949529,901 enrolled · 2011
HR 0.880.79 to 0.99
NCT039143269,651 enrolled · 2019
HR 0.860.77 to 0.96
NCT011790489,341 enrolled · 2010
HR 0.870.78 to 0.97
NCT038191533,533 enrolled · 2019
HR 0.760.66 to 0.88
NCT017204463,297 enrolled · 2013
HR 0.740.58 to 0.95
NCT026927163,183 enrolled · 2017
HR 0.790.57 to 1.11
Effects of Liraglutide on Clinical Stability Among Patients With Advan…PMID 27483064 · 300 enrolled · 2013
HR 1.100.57 to 2.14
[SURPASS CVOT : cardiovascular benefits with tirzepatide versus dulagl…PMID 41815032 · 2026
HR 0.840.75 to 0.94
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Review
  6. Review
  7. Article
  8. Review
  9. Review
  10. Review
  11. Review
  12. Review
  13. Review
  14. Review
  15. Review
  16. Review
  17. Review
  18. Article
  19. Review
  20. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

10 authors at 5 institutions in 6 countries.

João Sérgio NevesCardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.ORCID 0000-0002-8173-8255
Francisco Vasques-NóvoaCardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.
Marta Borges-CanhaCardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.ORCID 0000-0003-2929-3751
Ana Rita LeiteCardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.
Abhinav SharmaDivision of Cardiology, DREAM-CV Lab, McGill University Health Centre, Montreal, Canada.
Davide CarvalhoDepartment of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal.ORCID 0000-0002-3156-3741
Milton PackerBaylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas, USA.ORCID 0000-0003-1828-2387
Faiez ZannadUniversité de Lorraine, Inserm, Centre d'Investigations Cliniques, Plurithématique 14-33, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.
Adelino Leite-MoreiraCardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.
João Pedro FerreiraCardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.ORCID 0000-0002-2304-6138
Universidade do Porto · PTInserm · FRBaylor University Medical Center · USHospital de São João · PTMcGill University Health Centre · CA

Funding

Heart Failure Clinical Research Network Coordinating CenterU10HL084904 · NHLBI · DUKE UNIVERSITY · PI ANSTROM, KEVIN J, HERNANDEZ, ADRIAN · 2012 to 2018
$38.0M
NHLBI NIH HHS U10 HL084904
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

aimTo perform a post hoc analysis of the FIGHT trial, evaluating the effect of liraglutide (vs. placebo) on the totality of events in patients with heart failure with reduced ejection fraction (HFrEF). MATERIALS AND

methodsFIGHT was a double-blind randomized controlled trial (RCT) that studied liraglutide versus placebo in 300 recently hospitalized patients with HFrEF followed for 180 days. The main outcome of the present analysis was total events of hospitalizations for heart failure (HF) or all-cause death. Secondary outcomes included total arrhythmic events and prespecified total events of interest (arrhythmias, sudden cardiac death, acute coronary syndrome, worsening HF, cerebrovascular event, venous thromboembolism, lightheadedness, presyncope/syncope or worsening renal function). Treatment effect was evaluated with negative binomial regression.

resultsCompared to placebo, there was a trend towards increased risk with liraglutide of total HF hospitalizations or all-cause deaths (96 vs. 143 events, incidence rate ratio [IRR] 1.41, 95% confidence interval [CI] 0.98-2.04; P = 0.064) and total arrhythmias (21 vs. 39, IRR 1.76, 95% CI 0.92-3.37; P = 0.088). Total prespecified events of interest were increased with liraglutide compared to placebo (196 vs. 295, IRR 1.43, 95% CI 1.06-1.92; P = 0.018). The risk of HF hospitalizations or all-cause deaths with liraglutide was higher among patients in New York Heart Association (NYHA) Class III to IV (IRR 1.86, 95% CI 1.21-2.85) than in those in NYHA Class I to II (IRR 0.62, 95% CI 0.31-1.23; interaction P = 0.008), and among patients with diabetes (interaction P = 0.051). The risk of arrhythmic events was higher among those without an implanted cardiac device (interaction P = 0.047).

conclusionsIn patients with HFrEF, liraglutide might increase the risk of cardiovascular adverse effects, an effect possibly driven by excess risk of arrhythmias and worsening HF events. As this was a post hoc analysis, these results should be interpreted as exploratory and hypothesis-generating. Further RCTs must be conducted before drawing definitive conclusions.

Indexed as

Heart FailureLiraglutideHumansLiraglutideadverse eventsarrhythmiaGLP-1 receptor agonistsheart failure hospitalizationsheart failure with reduced ejection fractionliraglutide

Identifiers

PMID36082522
PMCPMC9742170
OpenAlexW4295084553

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.