The Section of Cardiology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
The Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA.
Cardiovasc Drugs Ther. 2018 Feb;32(1):65-72. doi: 10.1007/s10557-018-6773-2.
The aim of this study is to examine the cardioprotective properties of Glucagon-like peptide-1 receptor agonist, a class of antihyperglycemic therapy, via meta-analysis of four recently published cardiovascular outcomes trials.
Meta-analysis was performed pooling data from the ELIXA, LEADER, SUSTAIN-6 and EXSCEL trials. A random effects model was used to generate risk ratio with 95% confidence interval for cardiovascular and safety outcomes.
A total of 33,457 patients were included in the meta-analysis. Based on the study, GLP-1R agonists significantly reduced all-cause mortality (RR 0.89; 95% CI 0.82 to 0.96) and cardiovascular mortality (RR 0.88; 95% CI 0.80 to 0.97) when compared to placebo. When long-acting agents were analyzed alone, reduction in major adverse cardiac events (RR 0.88; 95% CI 0.81 to 0.97) and non-fatal strokes (RR 0.87; 95% CI 0.76 to 0.99) also showed significance.
Overall, GLP-1R agonists appear to have cardioprotective properties likely via modification of metabolic parameters such as glycemic control, weight loss, and improvement in blood pressure. Additional studies are warranted to compare cardiovascular outcomes among the different agents.
本研究旨在通过对四项最近发表的心血管结局试验进行荟萃分析，检验胰高血糖素样肽-1 受体激动剂（一类抗高血糖治疗药物）的心脏保护特性。
对 ELIXA、LEADER、SUSTAIN-6 和 EXSCEL 试验的数据进行荟萃分析。采用随机效应模型生成心血管和安全性结局的风险比及其 95%置信区间。
共有 33457 名患者纳入荟萃分析。研究表明，与安慰剂相比，GLP-1R 激动剂可显著降低全因死亡率（RR 0.89；95%CI 0.82 至 0.96）和心血管死亡率（RR 0.88；95%CI 0.80 至 0.97）。当单独分析长效制剂时，主要不良心脏事件（RR 0.88；95%CI 0.81 至 0.97）和非致死性卒中（RR 0.87；95%CI 0.76 至 0.99）的减少也具有统计学意义。
总体而言，GLP-1R 激动剂似乎具有心脏保护特性，可能通过改善血糖控制、体重减轻和血压等代谢参数来实现。需要进一步的研究来比较不同药物之间的心血管结局。
