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1.08 to 2.54; p ¼ 0.02) (C statistic without F-aGLP-1: 0.664; with F-aGLP-1: 0.705).The present study is the first to demonstrate significantly reduced plasma aGLP-1 levels in a fasting state and during 75g-OGTT in CAD patients. Lower aGLP-1 levels were significantly correlated with the presence of CAD. Furthermore, lower F-aGLP-1 levels were associated with severe coronary plaque complexity in CAD patients. These results suggested that there may be a pathophysiological link between endogenous aGLP-1 and CAD. Although previous reports have demonstrated that incretin-related drugs attenuated the development of atherosclerotic lesions in animal models (2), a large clinical study failed to demonstrate any benefit of dipeptidyl peptidase-4 inhibition on ischemic events in patients with established disease (3). Further studies are warranted to clarify clinical significance of GLP-1 in CAD.In summary, plasma aGLP-1 levels were significantly reduced in CAD patients, and lower plasma aGLP-1 levels were independently correlated with the presence of CAD and coronary plaque complexity. The gut-derived endogenous aGLP-1 may have a significant association with human coronary atherosclerosis.

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