AI Article Synopsis
- GLP-1 receptor agonists (GLP-1 RAs) show cardiovascular benefits for patients with type 2 diabetes, but their effectiveness in high-risk groups is still being investigated.
- A review of nine randomized controlled trials involving over 63,000 patients indicated that GLP-1 RAs significantly lower risks for key cardiovascular outcomes such as death and heart complications.
- The findings suggest that combining GLP-1 RAs with other treatments may offer greater advantages, particularly for patients with chronic kidney disease, although more studies are needed to understand long-term impacts.
Article Abstract
Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been shown to provide cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM). However, their cardiovascular protective efficacy in high-risk T2DM patients, particularly those with a history of cardiovascular events or severe chronic kidney disease, remains uncertain.
Methods: A comprehensive search was conducted in PubMed, Embase, Web of Science, and The Cochrane Library to identify randomized controlled trials (RCTs) that evaluated the effects of GLP-1 RAs on cardiovascular outcomes in high-risk patients with T2DM. A random-effects model was used to calculate pooled hazard ratios (HRs) for cardiovascular outcomes. Subgroup analyses and GRADE assessment were also performed.
Results: Nine RCTs involving 63,613 patients were included. GLP-1 RAs significantly reduced the risk of the primary composite outcome (HR: 0.86, 95% CI: 0.80-0.92), cardiovascular death (HR: 0.85, 95% CI: 0.78-0.93), all-cause death (HR: 0.87, 95% CI: 0.82-0.93), myocardial infarction (HR: 0.90, 95% CI: 0.82-0.98), stroke (HR: 0.85, 95% CI: 0.77-0.95), and heart failure (HF) hospitalization (HR: 0.90, 95% CI: 0.83-0.97). No significant difference in unstable angina (UA) hospitalization was observed (HR: 1.04, 95% CI: 0.95-1.15). Subgroup analyses indicated greater benefits with combination therapy, particularly in patients with chronic kidney disease. The quality of evidence was rated as "High" for six outcomes and "Moderate" for UA hospitalization.
Conclusions: GLP-1 RAs significantly reduce cardiovascular risk in high-risk T2DM patients, especially with combination therapy and in those with chronic kidney disease. However, further research is needed to confirm their long-term effects.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515276 | PMC |
| http://dx.doi.org/10.1186/s13098-024-01497-4 | DOI Listing |
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