Glucagon-like peptide-1 receptor agonists and cardiovascular outcomes in patients with and without prior cardiovascular events: An updated meta-analysis and subgroup analysis of randomized controlled trials.
Aged
Cardiovascular Diseases
/ complications
Cardiovascular System
/ drug effects
Diabetes Mellitus, Type 2
/ complications
Diabetic Angiopathies
/ drug therapy
Drug-Related Side Effects and Adverse Reactions
/ epidemiology
Female
Glucagon-Like Peptide-1 Receptor
/ agonists
Humans
Hypoglycemic Agents
/ therapeutic use
Male
Middle Aged
Randomized Controlled Trials as Topic
/ statistics & numerical data
Treatment Outcome
glucagon-like peptide-1 receptor agonists
major cardiovascular events
meta-analysis
mortality
Journal
Diabetes, obesity & metabolism
ISSN: 1463-1326
Titre abrégé: Diabetes Obes Metab
Pays: England
ID NLM: 100883645
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
31
07
2019
revised:
23
09
2019
accepted:
27
09
2019
pubmed:
9
10
2019
medline:
7
4
2021
entrez:
10
10
2019
Statut:
ppublish
Résumé
To conduct a meta-analysis of cardiovascular outcome trials on the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on major adverse cardiovascular events (MACE). A search of MEDLINE, EMBASE, Cochrane database and clinicaltrials.gov was performed to identify controlled trials (up to 15 June 2019) of GLP-1RAs with a cardiovascular endpoint. The principal endpoint of the present meta-analysis was MACE; secondary endpoints included myocardial infarction, stroke, cardiovascular and all-cause mortality, and hospitalization for heart failure. Mantel-Haenszel odds ratios (MH-ORs) with 95% confidence intervals (CIs) were calculated for all outcomes. In the seven trials included, all placebo-controlled, GLP-1RA treatment was associated with a reduction in MACE (MH-OR 0.87 [95% CI 0.81, 0.93]). Cardiovascular and all-cause mortality, myocardial infarction and stroke were also reduced (MH-OR 0.88 [95% CI 0.80, 0.96], MH-OR 0.90 [95% CI 0.82, 0.98], MH-OR 0.91 [95% CI 0.84, 0.98] and MH-OR 0.86 [95% CI 0.77, 0.97], respectively). Results for hospitalization for heart failure were not statistically significant (MH-OR 0.93 [95% CI 0.83, 1.04]). The meta-analyses of patient subgroups showed a significant reduction in MACE with GLP-1RAs, irrespective of gender, advanced age and obesity. GLP-1RAs are associated with a reduction in cardiovascular morbidity and mortality in high-risk patients with diabetes. This effect does not appear to be moderated by gender or body mass index. The possibility of different effects of GLP-1RAs between patients in primary and secondary prevention merits further investigation.
Substances chimiques
Glucagon-Like Peptide-1 Receptor
0
Hypoglycemic Agents
0
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
203-211Informations de copyright
© 2019 John Wiley & Sons Ltd.
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