Background: Glucagon-like peptide 1 (GLP-1) is a gut incretin hormone, which induces post-prandial glucose-dependent insulin secretion. GLP-1 receptor agonists improve cardiovascular outcomes in patients with diabetes at high cardiovascular risk. We found GLP-1 levels to be associated with cardiovascular events in patients with acute myocardial infarction. The aim of this study was to assess the predictive capacity of GLP-1 for cardiovascular outcomes in stable patients undergoing coronary angiography. 

Methods: We examined whether circulating total GLP-1 levels are associated with cardiovascular and total mortality in 3315 patients (all patients) from the Ludwigshafen Risk and Cardiovascular Health Study who underwent coronary angiography at baseline (1997-2000).

Results: Kaplan-Meier survival plots (separated by tertiles with cut-off values 0.5 and 1.1 ng/ml) and multivariable cox regression analyses found GLP-1 values to be independently associated with adverse outcome (endpoint: cardiovascular mortality; logarithmized GLP-1 values HR: 1.3; p=0.02 after adjustment for age, sex, diabetes, previous cardiovascular disease, hypertension, eGFR, LDL-C, hs-CRP and Troponin T). We found similar results for all-cause mortality (logarithmized GLP-1 values HR: 1.2; p=0.02 after adjustment for age, sex, diabetes, previous cardiovascular disease, hypertension, eGFR, LDL-C, hs-CRP and Troponin T).

Conclusion: In stable patients undergoing coronary angiography, GLP-1 levels are independently associated with all cause and cardiovascular mortality.