Department of Endocrinology and Metabolism, Rush University Medical Center, USA.
Department of Cardiology, Rush University Medical Center, USA.
Eur J Prev Cardiol. 2020 Dec;27(18):1922-1930. doi: 10.1177/2047487320903638. Epub 2020 Feb 23.
Glucagon-like peptide-1 receptor agonists (GLP1RAs) are relatively newer anti-hyperglycemic agents, which have demonstrated cardiovascular benefits in patients with type 2 diabetes mellitus.
We performed a meta-analysis of randomized controlled trials to evaluate the cardiovascular outcomes of GLP1RAs compared to placebo in type 2 diabetes mellitus patients. We performed an additional subgroup analysis to evaluate the role of GLP1RAs in patients with chronic kidney disease.
MEDLINE, Cochrane and ClinicalTrials.gov databases were searched from inception to 15 July 2019. The authors extracted relevant information from articles and independently assessed the study quality.
Compared to placebo, GLP1RAs demonstrated a significant reduction in all-cause mortality (odds ratio (OR) 0.88, 95% confidence interval (CI) 0.82-0.95; < 0.001), cardiovascular mortality (OR 0.88, 95% CI 0.81-0.96; = 0.004), primary composite endpoint (OR 0.86, 95% CI 0.80-0.91; < 0.001) and non-fatal stroke (OR 0.86, 95% 0.77-0.95; = 0.004). There was no statistical difference in non-fatal myocardial infarction (OR 0.92, 95% CI 0.83-1.01; = 0.09). In subgroup analyses of patients with estimated glomerular filtration rate less than 60 ml/min/1.73 m and less than 30 ml/min/1.73 m, there was no significant difference in the primary composite endpoint.
GLP1RAs demonstrated a significant reduction in all-cause mortality, cardiovascular mortality, primary composite endpoint and non-fatal stroke in patients with type 2 diabetes mellitus. There was no significant difference in the primary composite endpoint in patients with type 2 diabetes mellitus and chronic kidney disease.
胰高血糖素样肽-1 受体激动剂（GLP1RAs）是相对较新的抗高血糖药物，已证明其在 2 型糖尿病患者中有心血管获益。
我们对随机对照试验进行了荟萃分析，以评估 GLP1RAs 与安慰剂相比在 2 型糖尿病患者中的心血管结局。我们进行了额外的亚组分析，以评估 GLP1RAs 在慢性肾脏病患者中的作用。
从建立到 2019 年 7 月 15 日，我们在 MEDLINE、Cochrane 和 ClinicalTrials.gov 数据库中进行了搜索。作者从文章中提取了相关信息，并独立评估了研究质量。
与安慰剂相比，GLP1RAs 显著降低了全因死亡率（比值比（OR）0.88，95%置信区间（CI）0.82-0.95； < 0.001）、心血管死亡率（OR 0.88，95%CI 0.81-0.96； = 0.004）、主要复合终点（OR 0.86，95%CI 0.80-0.91； < 0.001）和非致死性卒中（OR 0.86，95%CI 0.77-0.95； = 0.004）。非致死性心肌梗死（OR 0.92，95%CI 0.83-1.01； = 0.09）无统计学差异。肾小球滤过率估计值小于 60 ml/min/1.73 m 和小于 30 ml/min/1.73 m 的患者亚组分析中，主要复合终点无显著差异。
GLP1RAs 显著降低了 2 型糖尿病患者的全因死亡率、心血管死亡率、主要复合终点和非致死性卒中。在 2 型糖尿病和慢性肾脏病患者中，主要复合终点无显著差异。
