UNASSIGNED: We included randomized clinical trials (RCTs) that explored the effects of different LDL-C lowering agents including alirocumab, evolocumab, and bempedoic acid in adult patients with cardiovascular disease. Several databases were searched from inception through 2022. The safety endpoint includes new-onset diabetes, serious adverse events, and neurocognitive disorders with at least 1 year of follow-up. The efficacy outcomes included composite adverse cardiovascular outcomes, all-cause death, and cardiovascular death.
UNASSIGNED: Seven RCTs comprising 53,106 patients were included in this research. Bempedoic acid ranked first in reducing the risk of new-onset diabetes (risk ratio [RR] 0.72, 95% credible interval [CrI] 0.52-0.99) and risk of the composite cardiovascular outcome (RR 0.75, 95% CrI 0.57-0.99). Meta-regression analysis demonstrated that elevated risk of new-onset diabetes was positively correlated with a significant reduction in LDL-C levels (p = 0.03). All treatment agents were associated with a decreased risk of a composite adverse cardiovascular outcome.
UNASSIGNED: The present analysis showed that bempedoic acid ranked first in reducing the risk of a composite cardiovascular outcome. In addition, it ranked first in reducing the risk of new-onset diabetes compared with placebo and evolocumab. Our analysis also suggests that the increased risk of new-onset diabetes might be associated with a reduction in LDL-C levels. Besides, the present analysis found that alirocumab ranked first in decreasing all-cause mortality and cardiovascular mortality.
■我们纳入了随机临床试验(RCT),这些试验探讨了包括alirocumab在内的不同LDL-C降低药物的作用,evolocumab,和bempedoic酸在成人心血管疾病患者中的作用。从成立到2022年,搜索了几个数据库。安全终点包括新发糖尿病,严重不良事件,和神经认知障碍至少1年的随访。疗效结果包括复合不良心血管结果,全因死亡,心血管死亡。
■7项RCTs包括53,106名患者纳入本研究。Bempedoicacid在降低新发糖尿病风险(风险比[RR]0.72,95%可信区间[CrI]0.52-0.99)和复合心血管结局风险(RR0.75,95%CrI0.57-0.99)方面排名第一。荟萃回归分析表明,新发糖尿病的风险升高与LDL-C水平的显着降低呈正相关(p=0.03)。所有治疗药物均与降低复合不良心血管结局的风险相关。
■目前的分析表明,bempedoicacid在降低复合心血管结局的风险方面排名第一。此外,与安慰剂和evolocumab相比,它在降低新发糖尿病风险方面排名第一.我们的分析还表明,新发糖尿病的风险增加可能与LDL-C水平降低有关。此外,本分析发现,alirocumab在降低全因死亡率和心血管死亡率方面排名第一.