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Meta-Analysis
. 2023 Apr:25 Suppl 1:53-63.
doi: 10.1111/dom.15043. Epub 2023 Mar 31.

Effects of glucagon-like peptide-1 receptor agonists on major coronary events in patients with type 2 diabetes

Xueyuan Guo  1 , Caihua Sang  1 , Ribo Tang  1 , Chenxi Jiang  1 , Songnan Li  1 , Nian Liu  1 , Deyong Long  1 , Xin Du  1 , Jianzeng Dong  1 , Changsheng Ma  1
Affiliations
Meta-Analysis

Effects of glucagon-like peptide-1 receptor agonists on major coronary events in patients with type 2 diabetes

Xueyuan Guo et al. Diabetes Obes Metab. 2023 Apr.

Abstract

Aims: To perform a meta-analysis to assess the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on major coronary events, including myocardial infarction (MI), unstable angina and coronary revascularization, in patients with type 2 diabetes mellitus (T2DM).

Materials and methods: We systematically searched the PubMed, CENTRAL, EMBASE and clinicaltrial.gov databases to seek eligible studies with a cardiovascular endpoint comparing GLP-1RAs with a placebo in T2DM patients. Odds ratio (ORs) and 95% confidence intervals (CIs) were calculated for the outcomes.

Results: Nine studies, with a total of 64 236 patients, were included. GLP-1RA treatment reduced fatal and nonfatal MI by 8% (OR 0.92, 95% CI 0.86-0.99; P = 0.02, I2 = 39%). The reduction reached 15% in human-based GLP-1RA-treated patients. Similarly, once-weekly GLP-1RA treatment reduced the risk of MI by 13%. In contrast, GLP-1RA treatment did not reduce the risk of hospitalization for unstable angina (OR 1.11, 95% CI 0.97-1.28; P = 0.13, I2 = 21%). GLP-1RAs exhibited a tendency to lower the risk of coronary revascularization (OR 0.95, 95% CI 0.89-1.02; P = 0.15, I2 = 22%), but without statistical significance. Human-based GLP-1RAs decreased the risk by 11%.

Conclusions: In high-risk patients with T2DM, GLP-1RAs were associated with a decrease in MI, especially the human-based and once-weekly GLP-1RAs. No benefit was seen for hospitalization for unstable angina or coronary revascularization. Further research is urgently needed to ascertain improvements in coronary events.

Keywords: coronary events; glucagon-like peptide-1 receptor agonists; meta-analysis; type 2 diabetes mellitus.

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References

REFERENCES

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