Qiu Mei, Wei Xu-Bin, Wei Wei
Department of General Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, China.
Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Front Cardiovasc Med. 2021 Dec 7;8:791311. doi: 10.3389/fcvm.2021.791311. eCollection 2021.
Lin et al. recently did a network meta-analysis based on cardiovascular (CV) outcome trials (CVOTs) of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and those of glucagon-like peptide-1 receptor agonists (GLP1RAs). Due to the absence of CVOTs directly comparing SGLT2is with GLP1RAs, Lin et al.'s network meta-analysis identified the indirect evidence that SGLT2is vs. GLP1RAs reduced hospitalization for heart failure (HHF) but did not reduce CV death and all-cause mortality (ACM) in patients with type 2 diabetes (T2D). We did another meta-analysis incorporating those CV outcome cohort studies directly comparing SGLT2is with GLP1RAs, and identified that SGLT2is vs. GLP1RAs were significantly associated with the lower risks of not only HHF but also CV death and ACM. These findings may suggest that SGLT2is should be considered over GLP1RAs in terms of preventing CV and all-cause death and HHF in T2D patients.
林等人最近基于钠-葡萄糖协同转运蛋白2抑制剂（SGLT2is）和胰高血糖素样肽-1受体激动剂（GLP1RAs）的心血管（CV）结局试验（CVOTs）进行了一项网络荟萃分析。由于缺乏直接比较SGLT2is与GLP1RAs的CVOTs，林等人的网络荟萃分析确定了间接证据，即SGLT2is与GLP1RAs相比可降低2型糖尿病（T2D）患者的心力衰竭住院率（HHF），但并未降低CV死亡和全因死亡率（ACM）。我们进行了另一项荟萃分析，纳入了那些直接比较SGLT2is与GLP1RAs的CV结局队列研究，并确定SGLT2is与GLP1RAs相比不仅与较低的HHF风险显著相关，而且与CV死亡和ACM风险也显著相关。这些发现可能表明，在预防T2D患者的CV死亡、全因死亡和HHF方面，应优先考虑SGLT2is而非GLP1RAs。
