Abstract：
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been pivotal in the management of type 2 diabetes mellitus (T2DM) and in the reduction of major adverse cardiovascular events (MACE). Notably, large cardiovascular outcomes trials (CVOTs) demonstrate significant disparities in inclusion, based on sex, race, ethnicity, and geographical regions.
OBJECTIVE: We examined the impact of GLP-1RA on MACE in patients with or without T2DM, based on sex, race, ethnicity, and geography.
METHODS: A literature search for placebo controlled RCTs on GLP-1RA treatment was conducted. Thorough data extraction and quality assessment were carried out, focusing on key outcome, and ensuring a robust statistical analysis using a random effects model to calculate log odds ratio with 95% confidence intervals (CIs).
RESULTS: A total of 8 CVOTs comprising 71,616 patients were included. Compared with placebo, GLP-1RAs significantly reduced MACE in both sexes (females: logOR -0.19, (95% CI, -0.28 to -0.10), p < 0.01] versus males: logOR -0.17, 95% CI, -0.23 to -0.10), p < 0.01], (p interaction NS)], and among Asians (logOR -34 (95% CI, -0.53 to -0.15, p < 0.01), and Whites (logOR -17 (95% CI, -0.25 to -0.09, p < 0.01), with no difference in MACE among Blacks and Hispanics. Odds of MACE were also reduced in Asia (logOR -31 (95% CI, -0.50 to -0.11, p < 0.01), and Europe (logOR -27 (95% CI, -0.40 to -0.13, p < 0.01), but there was no statistical difference in MACE in North America and Latin America.
CONCLUSIONS: Significant reductions in MACE with GLP-1RA treatment were demonstrated between both sexes and across certain ethnicities and certain geographical regions.
OBJECTIVE: We examined the impact of GLP-1RA on MACE in patients with or without T2DM, based on sex, race, ethnicity, and geography.
METHODS: A literature search for placebo controlled RCTs on GLP-1RA treatment was conducted. Thorough data extraction and quality assessment were carried out, focusing on key outcome, and ensuring a robust statistical analysis using a random effects model to calculate log odds ratio with 95% confidence intervals (CIs).
RESULTS: A total of 8 CVOTs comprising 71,616 patients were included. Compared with placebo, GLP-1RAs significantly reduced MACE in both sexes (females: logOR -0.19, (95% CI, -0.28 to -0.10), p < 0.01] versus males: logOR -0.17, 95% CI, -0.23 to -0.10), p < 0.01], (p interaction NS)], and among Asians (logOR -34 (95% CI, -0.53 to -0.15, p < 0.01), and Whites (logOR -17 (95% CI, -0.25 to -0.09, p < 0.01), with no difference in MACE among Blacks and Hispanics. Odds of MACE were also reduced in Asia (logOR -31 (95% CI, -0.50 to -0.11, p < 0.01), and Europe (logOR -27 (95% CI, -0.40 to -0.13, p < 0.01), but there was no statistical difference in MACE in North America and Latin America.
CONCLUSIONS: Significant reductions in MACE with GLP-1RA treatment were demonstrated between both sexes and across certain ethnicities and certain geographical regions.
摘要：
背景：胰高血糖素样肽-1受体激动剂（GLP-1RAs）在2型糖尿病（T2DM）的治疗和主要不良心血管事件（MACE）的减少中起着关键作用。值得注意的是,大型心血管结局试验(CVOTs)在纳入方面表现出显著差异，基于性别，种族,种族,和地理区域。
目的：我们研究了GLP-1RA对有或没有T2DM患者MACE的影响，基于性别，种族,种族,和地理。
方法：对GLP-1RA治疗的安慰剂对照随机对照试验进行文献检索。进行了彻底的数据提取和质量评估，专注于关键成果，并确保使用随机效应模型进行稳健的统计分析，以95％的置信区间（CI）计算对数比值比。
结果：共纳入8例CVOT，包括71,616例患者。与安慰剂相比，GLP-1RA显着降低男女MACE（女性：logOR-0.19，（95％CI，-0.28至-0.10），p<0.01]与男性相比：logOR-0.17，95%CI，-0.23至-0.10），p<0.01],(p交互NS)]，在亚洲人中(logOR-34(95%CI，-0.53至-0.15，p<0.01)，和白人(logOR-17(95%CI，-0.25至-0.09，p<0.01)，黑人和西班牙裔的MACE没有差异。亚洲的MACE几率也降低(logOR-31(95%CI,-0.50至-0.11,p<0.01),和欧洲(logOR-27(95%CI，-0.40至-0.13，p<0.01)，但北美和拉丁美洲的MACE没有统计学差异。
结论：GLP-1RA治疗的MACE显著降低在男女之间以及在某些种族和某些地理区域中得到证实。
目的：我们研究了GLP-1RA对有或没有T2DM患者MACE的影响，基于性别，种族,种族,和地理。
方法：对GLP-1RA治疗的安慰剂对照随机对照试验进行文献检索。进行了彻底的数据提取和质量评估，专注于关键成果，并确保使用随机效应模型进行稳健的统计分析，以95％的置信区间（CI）计算对数比值比。
结果：共纳入8例CVOT，包括71,616例患者。与安慰剂相比，GLP-1RA显着降低男女MACE（女性：logOR-0.19，（95％CI，-0.28至-0.10），p<0.01]与男性相比：logOR-0.17，95%CI，-0.23至-0.10），p<0.01],(p交互NS)]，在亚洲人中(logOR-34(95%CI，-0.53至-0.15，p<0.01)，和白人(logOR-17(95%CI，-0.25至-0.09，p<0.01)，黑人和西班牙裔的MACE没有差异。亚洲的MACE几率也降低(logOR-31(95%CI,-0.50至-0.11,p<0.01),和欧洲(logOR-27(95%CI，-0.40至-0.13，p<0.01)，但北美和拉丁美洲的MACE没有统计学差异。
结论：GLP-1RA治疗的MACE显著降低在男女之间以及在某些种族和某些地理区域中得到证实。
