司美格鲁肽对射血分数保留的心力衰竭患者的心血管影响：一项系统评价和荟萃分析
Cardiovascular Effects of Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis.
作者信息
Sobral Milene Vitória Sampaio, Rodrigues Livia Kneipp, Barbosa Abner Mácola Pacheco, da Rocha Naila Camila, Moulaz Isac Ribeiro, Dos Santos João Pedro Pereira, Oliveira Bruno Henrique Couto, Moreira João Lucas de Magalhães Leal, Pacagnelli Francis Lopes, Guida Camila Mota
机构信息
University of Western Sao Paulo, Presidente Prudente, Brazil.
Federal University of Minas Gerais, Belo Horizonte, Brazil.
出版信息
Am J Cardiovasc Drugs. 2025 Feb 5. doi: 10.1007/s40256-025-00721-4.
BACKGROUND
Semaglutide has emerged as an effective medication for treating type 2 diabetes mellitus (DM). However, the cardiovascular effects and safety of this agent in patients with heart failure with preserved ejection fraction (HFpEF) are unclear.
OBJECTIVE
This systematic review and meta-analysis aimed to assess the clinical and laboratory effects of semaglutide compared to placebo in patients with HFpEF.
METHODS
We systematically searched EMBASE, PubMed, and Cochrane databases for randomized controlled trials (RCTs) and non-randomized cohorts, from inception to July 2024, comparing semaglutide versus placebo in patients with HFpEF. Statistical analyses were performed using R Studio 4.3.2. Mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CIs) were pooled across trials.
RESULTS
This meta-analysis included three studies, two RCTs and one non-randomized cohort, reporting data on 1463 patients. The follow-up time of the studies was 52 weeks. Compared to placebo, the use of semaglutide was associated with a significant increase in the 6-min walk distance (MD 16.20; 95% CI 10.19-22.21; p < 0.01; I = 0%). Additionally, reductions were observed in systolic blood pressure (MD -2.22; 95% CI -3.60 to -0.83; p < 0.01; I = 0%), C-reactive protein level (MD 0.59; 95% CI 0.49-0.70; p < 0.01; I = 51%), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels (MD 0.81; 95% CI 0.74-0.89; p < 0.01; I = 0%).
CONCLUSION
These findings suggest that the use of semaglutide is associated with clinical and laboratory benefits in patients with HFpEF.
背景
司美格鲁肽已成为治疗2型糖尿病（DM）的有效药物。然而，该药物在射血分数保留的心力衰竭（HFpEF）患者中的心血管效应和安全性尚不清楚。
目的
本系统评价和荟萃分析旨在评估与安慰剂相比，司美格鲁肽对HFpEF患者的临床和实验室效应。
方法
我们系统检索了EMBASE、PubMed和Cochrane数据库，以查找从数据库建立至2024年7月期间，比较司美格鲁肽与安慰剂治疗HFpEF患者的随机对照试验（RCT）和非随机队列研究。使用R Studio 4.3.2进行统计分析。汇总各试验的平均差（MD）和比值比（OR）及其95%置信区间（CI）。
结果
该荟萃分析纳入了三项研究，两项RCT和一项非随机队列研究，共报告了1463例患者的数据。研究的随访时间为52周。与安慰剂相比，使用司美格鲁肽与6分钟步行距离显著增加相关（MD 16.20；95%CI 10.19-22.21；p<0.01；I=0%）。此外，收缩压（MD -2.22；95%CI -3.60至-0.83；p<0.01；I=0%）、C反应蛋白水平（MD 0.59；95%CI 0.49-0.70；p<0.01；I=51%）和脑钠肽前体N末端（NT-proBNP）水平（MD 0.81；95%CI 0.74-0.89；p<0.01；I=0%）均有所降低。
结论
这些发现表明，使用司美格鲁肽对HFpEF患者具有临床和实验室益处。
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