Association Between the Magnitude of Glycemic Control and Body Weight Loss With GLP-1 Receptor Agonists and Risk of Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-analyses of Randomized Diabetes Cardiovascular Outcomes Trials.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Drugs and Therapy Pub Date : 2025-04-01 Epub Date: 2024-01-12 DOI:10.1007/s10557-024-07547-3

Daniel A Gomes, João Presume, Pedro de Araújo Gonçalves, Manuel Sousa Almeida, Miguel Mendes, Jorge Ferreira

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引用次数: 0

Abstract

Purpose: Reduction of major atherosclerotic cardiovascular events (MACE) has not been consistent among different glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to assess the association between the magnitude of glycemic control, body weight loss, and reductions in systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C) achieved through GLP-1 RA therapy and MACE.

Methods: Electronic databases (MEDLINE, CENTRAL, SCOPUS) were searched through March 2023. Studies were eligible if they were cardiovascular outcome trials (CVOTs) comparing GLP-1 RAs versus placebo in T2DM patients. The outcome of interest was 3-point MACE - cardiovascular death, myocardial infarction, or stroke. Random-effects meta-regression analyses evaluated the associations between reductions of HbA_1c, body weight, SBP and LDL-C and reduction of MACE.

Results: Overall, 8 CVOTs were included (60079 patients, 30693 with GLP-1 RAs). Reductions of HbA_1C were associated with the reduction of 3P-MACE (Log RR -0.290 [95% CI -0.515;-0.064], p = 0.012), with an estimated RR reduction of 25% for each 1% absolute reduction in HbA_1C levels. Body weight loss was associated with the reduction of 3P-MACE (Log RR -0.068 [95% CI -0.135;-0.001], p = 0.047), with an estimated RR reduction of 7% for each 1 kg reduction in body weight. Reductions of SBP (Log RR -0.058 [95% CI -0.192;0.076], p = 0.396) and LDL-C (Log RR -0.602 [95% CI -4.157;2.953], p = 0.740) were not associated with the reduction of 3P-MACE.

Conclusions: In T2DM patients, more potent GLP-1 RAs in reducing HbA1c and body weight were associated with greater reductions of MACE.

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使用 GLP-1 受体激动剂控制血糖和减轻体重的幅度与动脉粥样硬化性心血管疾病风险之间的关系：随机糖尿病心血管结果试验的系统回顾和元分析》。

目的：不同的胰高血糖素样肽-1受体激动剂（GLP-1 RA）对2型糖尿病（T2DM）患者主要动脉粥样硬化性心血管事件（MACE）的降低作用并不一致。本研究旨在评估通过 GLP-1 RA 治疗实现的血糖控制、体重减轻、收缩压（SBP）和低密度脂蛋白胆固醇（LDL-C）降低的程度与 MACE 之间的关系：检索电子数据库（MEDLINE、CENTRAL、SCOPUS）至 2023 年 3 月。只要是比较 GLP-1 RA 与安慰剂治疗 T2DM 患者的心血管结果试验 (CVOT) 的研究均符合条件。关注的结果是3点MACE--心血管死亡、心肌梗死或中风。随机效应元回归分析评估了降低 HbA1c、体重、SBP 和 LDL-C 与减少 MACE 之间的关系：总共纳入了 8 项 CVOT（60079 名患者，30693 名使用 GLP-1 RAs）。HbA1C 的降低与 3P-MACE 的减少有关（Log RR -0.290 [95% CI -0.515;-0.064]，p = 0.012），HbA1C 水平每绝对降低 1%，RR 估计降低 25%。体重减轻与 3P-MACE 减少有关（Log RR -0.068 [95% CI -0.135;-0.001]，p = 0.047），体重每减轻 1 公斤，估计 RR 降低 7%。SBP（Log RR -0.058 [95% CI -0.192;0.076]，p = 0.396）和LDL-C（Log RR -0.602 [95% CI -4.157;2.953]，p = 0.740）的降低与3P-MACE的降低无关：在 T2DM 患者中，GLP-1 RAs 在降低 HbA1c 和体重方面的作用更强，与 MACE 的降低幅度更大相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Drugs and Therapy 医学-心血管系统

CiteScore

8.30

自引率

0.00%

发文量

110

审稿时长

4.5 months

期刊介绍： Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.