评估胰高血糖素样肽-1 受体激动剂对主要心脏心律失常影响的心血管结局试验的荟萃分析。
Meta-analysis of cardiovascular outcome trials assessing the impact of glucagon-like peptide-1 receptor agonists on major cardiac arrhythmias.
机构信息
Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Second Propaedeutic Department of Internal Medicine, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
出版信息
Acta Cardiol. 2023 Jul;78(5):519-524. doi: 10.1080/00015385.2022.2087839. Epub 2022 Jun 14.
OBJECTIVE
Glucagon-like peptide-1 receptor agonists (GLP-1RAs), a group of novel antidiabetic agents, demonstrated beneficial cardiovascular effects in recent large, placebo-controlled randomised clinical trials (RCTs); their clear antiarrhythmic benefit has not been yet underlined. The purpose of the present meta-analysis is to clarify the impact of GLP-1RAs on different types of cardiac arrhythmias.
METHODS
We searched PubMed from its inception up to 8 October 2020 for all available cardiovascular and renal outcome, placebo-controlled RCTs utilising GLP-1RAs versus placebo. The present meta-analysis is reported according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) statement.
RESULTS
We included data from 7 RCTs with GLP-1RAs in a total of 55,943 participants. Treatment with GLP-1RAs did not provide significant benefit in the risk for atrial fibrillation (RR = 0.81, 95%CI; 0.78-1.15, = 51%), atrial flutter (RR = 0.79, 95%CI; 0.53-1.16, = 0%), ventricular fibrillation (RR = 0.99, 95%CI; 0.48-2.04, = 0%), ventricular tachycardia (RR = 1.41, 95%CI; 0.87-2.28, = 10%), atrial tachycardia (RR = 0.63, 95%CI; 0.10-3.90, = 24%), sinus node dysfunction (RR = 0.70, 95%CI; 0.40-1.23, = 0%), ventricular extrasystoles (RR = 1.37, 95%CI; 0.56-3.30, = 0%), second-degree atrioventricular block (RR = 0.96, 95%CI; 0.52-1.74, = 0%) or complete atrioventricular block (RR = 0.78, 95%CI; 0.39-1.54, = 38%).
CONCLUSIONS
In patients with type 2 diabetes mellitus, treatment with GLP-1RAs does not significantly affect the risk for major cardiac arrhythmias.
目的
胰高血糖素样肽-1 受体激动剂（GLP-1RAs）是一组新型抗糖尿病药物，最近的大型安慰剂对照随机临床试验（RCT）表明它们具有有益的心血管作用；它们明确的抗心律失常益处尚未得到强调。本荟萃分析的目的是阐明 GLP-1RAs 对不同类型的心律失常的影响。
方法
我们从其成立到 2020 年 10 月 8 日在 PubMed 上搜索了所有可用的心血管和肾脏结局的 GLP-1RA 与安慰剂对照的 RCT 数据。本荟萃分析根据系统评价和荟萃分析的首选报告项目（PRISMA）声明进行报告。
结果
我们纳入了 7 项 GLP-1RA 治疗的 RCT 数据，共纳入 55943 名参与者。GLP-1RA 治疗并未显著降低心房颤动（RR = 0.81，95%CI；0.78-1.15， = 51%）、心房扑动（RR = 0.79，95%CI；0.53-1.16， = 0%）、心室颤动（RR = 0.99，95%CI；0.48-2.04， = 0%）、室性心动过速（RR = 1.41，95%CI；0.87-2.28， = 10%）、心房性心动过速（RR = 0.63，95%CI；0.10-3.90， = 24%）、窦房结功能障碍（RR = 0.70，95%CI；0.40-1.23， = 0%）、室性期前收缩（RR = 1.37，95%CI；0.56-3.30， = 0%）、二度房室传导阻滞（RR = 0.96，95%CI；0.52-1.74， = 0%）或完全性房室传导阻滞（RR = 0.78，95%CI；0.39-1.54， = 38%）的风险。
结论
在 2 型糖尿病患者中，GLP-1RA 治疗并未显著影响主要心律失常的风险。
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