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GLP-1受体激动剂在心力衰竭患者中的安全性和有效性:一项系统评价和荟萃分析。

The Safety and Efficacy of GLP-1 Receptor Agonists in Heart Failure Patients: A Systematic Review and Meta-Analysis.

作者信息

Merza Nooraldin, Akram Moeez, Mengal Aqsa, Rashid Ahmed Mustafa, Mahboob Anber, Faryad Mawwra, Fatima Zairah, Ahmed Muhammad, Ansari Saad Ali

机构信息

Department of Internal Medicine, University of Toledo, Ohio, USA.

Allama Iqbal Medical College, Lahore, Pakistan.

出版信息

Curr Probl Cardiol. 2023 May;48(5):101602. doi: 10.1016/j.cpcardiol.2023.101602. Epub 2023 Jan 20.

Abstract

Evaluation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) usage in heart failure (HF) patients with or without type 2 diabetes mellitus (T2DM) could be proven to be a critical breakthrough in treatment options available for these patients. Our study focuses on understanding the safety and efficacy of GLP-1 RAs in this patient population by pooling the data from 9 randomized controlled trials (RCTs) comprising 871 subjects. As compared with the placebo, GLP-1 RAs did not improve major adverse cardiovascular events (MACE) which include cardiovascular (CV) mortality and heart failure (HF) hospitalizations, our primary outcome. CV mortality (RR = 1.03, 95% CI = 0.56-1.88, P = 0.92) and HF hospitalizations (RR = 1.18, 95%CI = 0.93-1.51, P = 0.18). Similarly, GLP-1 RAs did not improve our secondary findings of left ventricular ejection fraction (LVEF) and 6-minute walk test (6MWT). LVEF (RR = 1.96, 95%CI = -0.16-4.07, P = 0.07) or 6 MWT (RR = 8.43, 95% CI = -2.69-19.56, P = 0.14). This meta-analysis shows that GLP-1 RAs do not improve cardiovascular outcomes in HF patients with or without T2DM.

摘要

评估胰高血糖素样肽-1受体激动剂(GLP-1 RAs)在伴有或不伴有2型糖尿病(T2DM)的心力衰竭(HF)患者中的应用,可能会被证明是这些患者现有治疗选择中的一项关键突破。我们的研究通过汇总来自9项包含871名受试者的随机对照试验(RCT)的数据,着重了解GLP-1 RAs在这一患者群体中的安全性和有效性。与安慰剂相比,GLP-1 RAs并未改善主要不良心血管事件(MACE),包括心血管(CV)死亡率和心力衰竭(HF)住院率,这是我们的主要结局。CV死亡率(RR = 1.03,95% CI = 0.56 - 1.88,P = 0.92)和HF住院率(RR = 1.18,95%CI = 0.93 - 1.51,P = 0.18)。同样,GLP-1 RAs也未改善我们关于左心室射血分数(LVEF)和6分钟步行试验(6MWT)的次要研究结果。LVEF(RR = 1.96,95%CI = -0.16 - 4.07,P = 0.07)或6MWT(RR = 8.43,95% CI = -2.69 - 19.56,P = 0.14)。这项荟萃分析表明,GLP-1 RAs并不能改善伴有或不伴有T2DM的HF患者的心血管结局。

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