Cardiovascular Outcomes with Exenatide in Type 2 Diabetes According to Ejection Fraction: The Exenatide Study of Cardiovascular Event Lowering (EXSCEL) Trial
Authors' conclusion
The EQW effect on HHF was influenced by LVEF, with a potentially decreased risk in participants with LVEF ≥40% and increased risk in those with LVEF <40%.
Study context
- Population
- People with T2D in EXSCEL with baseline left ventricular ejection fraction (LVEF) available (LVEF <40% or ≥40%)LVEF available
- Participants
- 4,749 people
- Comparison
- Once-weekly exenatide vs placebo, by baseline LVEF
- Primary endpoint
- Hospitalization for HF (HHF)
Methodological detailssubgroup analysis by baseline LVEF
- Subgroup analysis by baseline LVEF
Primary result
As reported in the abstract
HHF by baseline LVEF
EQW vs PlaceboHazard ratio (95% CI)
LVEF <40% (n = 455)
1.52(0.95–2.43)
LVEF ≥40% (n = 4294)
0.74(0.55–1.01)
Further findings
Major adverse cardiovascular events (MACE), CV death, all-cause mortality, by LVEF (<40% vs ≥40%)
- No significant treatment-by-LVEF interactions
- P for interaction > 0.10
- Post-hoc analysis
Hospitalization for heart failure (HHF), by baseline New York Heart Association (NYHA) class (subgroup)
- NYHA class I/II: HR
- 0.91 (0.65-1.27) (95% CI)
- NYHA class III/IV: HR
- 1.84 (0.95-3.59) (95% CI)
- Interaction p = 0.062
- Mostly driven by the LVEF <40% subgroup
- Post-hoc analysis
HHF, by obesity (subgroup)
- Obesity did not modify the effects of EQW on HHF
- Post-hoc analysis
Original publication
Cardiovascular Outcomes with Exenatide in Type 2 Diabetes According to Ejection Fraction: The EXSCEL Trial. Eur J Heart Fail. Published 9 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it