UNASSIGNED: Systematically, the databases were searched for observational studies reporting compound CV events and deaths in type 2 diabetics without having the risk of cardiovascular diseases (CVDs) compared to other glucose-lowering agents. A meta-analysis was carried out using random effects model to estimate the overall hazard ratio (HR) with a 95% confidence interval (CI). Five studies were found eligible for the systematic review including a total of 64,452 patients receiving either liraglutide (three studies) or exenatide (two studies).
UNASSIGNED: The pooled HR for major adverse cardiac event (MACE) and extended MACE was 0.72 (95% CI: 0.65 - 0.93, I2 = 68%) and 0.93 (95% CI: 0.89 - 0.98, I2 = 29%), respectively. The pooled HR for hospitalization due to heart failure (HHF) and occurrence of HF was 0.84 (95% CI: 0.77 - 0.91, I2 = 79%) and 0.83 (95% CI: 0.75 - 0.94, I2 = 95%), respectively. For stroke, GLP-1 RA was associated with a significant risk reduction of 0.86 (95% CI: 0.75 - 0.98, I2 = 81%). There was no significant myocardial infarction (MI) risk reduction with GLP-1 RA. As for all-cause mortality, the pooled HR for the occurrence of all-cause mortality was 0.82 (95% CI: 0.76 - 0.88, I2 = 0%). The pooled HR for the occurrence of CV death was 0.75 (95% CI: 0.65 - 0.85, I2 = 38%). GLP-1 RA therapy was associated with a significantly low risk of MACE, extended MACE, all-cause mortality, and CV mortality. Except for MACE, the heterogenicity among the studies was low.
UNASSIGNED: We conclude that GLP-1 RA is associated with a low risk of CV events composites and mortality. The findings support the cardioprotective effect of GLP-1 RA.
■系统,我们在数据库中搜索了报告与其他降糖药相比,无心血管疾病(CVDs)风险的2型糖尿病患者复合CV事件和死亡的观察性研究.使用随机效应模型进行荟萃分析,以95%置信区间(CI)估计总体风险比(HR)。五项研究被发现符合系统评价的条件,包括总共64,452名接受利拉鲁肽(三项研究)或艾塞那肽(两项研究)的患者。
■主要不良心脏事件(MACE)和延长MACE的合并HR分别为0.72(95%CI:0.65-0.93,I2=68%)和0.93(95%CI:0.89-0.98,I2=29%),分别。因心力衰竭(HHF)和HF发生而住院的合并HR为0.84(95%CI:0.77-0.91,I2=79%)和0.83(95%CI:0.75-0.94,I2=95%),分别。对于中风,GLP-1RA与0.86的显著风险降低相关(95%CI:0.75-0.98,I2=81%)。GLP-1RA没有显著降低心肌梗死(MI)风险。至于全因死亡率,全因死亡率的合并HR为0.82(95%CI:0.76~0.88,I2=0%).CV死亡发生的合并HR为0.75(95%CI:0.65-0.85,I2=38%)。GLP-1RA治疗与MACE的低风险相关,扩展MACE,全因死亡率,和CV死亡率。除了MACE,研究之间的异质性较低。
■我们得出结论,GLP-1RA与CV事件复合和死亡率的低风险相关。研究结果支持GLP-1RA的心脏保护作用。