Impact of glp-1 receptor agonists on hospitalization for heart failure and all-cause death in patients with diabetes with and without heart failure: a real-world study.

IF 3.8 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Luisa Ojeda-Fernández, Ginevra Torrigiani, Mauro Molteni, Ida Fortino, Claudio Cimminiello, Marta Baviera
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引用次数: 0

Abstract

Objective: Evidence on the impact of GLP-1 RAs on HF hospitalization (HHF) and mortality has been inconsistent across clinical trials in patients with diabetes. We investigated the association between GLP-1 RAs and these outcomes in a real-world setting.

Methods: We selected individuals aged 45 years and older already treated with metformin living in Lombardy, Italy, and then split them into two groups if they initiated GLP-1 RAs or other antidiabetic drugs, between 2019 and 2021. A multivariable Cox proportional hazard regression model was performed to assess the association of GLP-1 RAs on HHF and all-cause death as hazard ratios (HRs) with 95% CI compared to the Other ADs group, stratifying by history of HF. The role of GLP-1 RAs was also investigated using the Inverse Probability Treatment Weighting (IPTW) and in the subgroup analyses.

Results: In total, 9795 patients in the GLP-1 RAs group (302 with HF; 9493 without) and 6018 in the Other ADs group (405 with HF; 5613 without) were included in the analysis. GLP-1 RAs use was significantly associated with a lower risk of HHF in patients with a history of HF (HR 0.65; CI 95% 0.426-0.987) and in those without (HR 0.52; CI 95% 0.371-0.733). A lower risk for all-cause death was also observed in GLP-1 RAs users (with HF: HR 0.45; CI 95% 0.320-0.638; without HF: HR 0.44; CI 95% 0.383-0.514). The results of the IPTW and subgroup analyses confirmed those of the main analysis.

Conclusion: Our findings showed a benefit of GLP-1 RAs on HHF and all-cause death in patients with diabetes regardless of HF history. Although, our study presents several limitations, if confirmed through dedicated randomized trial, this could further expand the role of GLP-1RAs in cardiovascular prevention".

glp-1受体激动剂对伴有和不伴有心力衰竭的糖尿病患者心力衰竭住院治疗和全因死亡的影响:一项真实世界的研究
目的:在糖尿病患者的临床试验中,关于GLP-1 RAs对HF住院率(HHF)和死亡率影响的证据并不一致。我们在现实环境中研究了GLP-1 RAs与这些结果之间的关系。方法:我们选择居住在意大利伦巴第的45岁及以上已经接受二甲双胍治疗的个体,然后将他们分成两组,如果他们在2019年至2021年期间开始使用GLP-1 RAs或其他降糖药物。采用多变量Cox比例风险回归模型评估GLP-1 RAs与HHF和全因死亡的关系,与其他ad组相比,风险比(hr)为95% CI,按HF病史分层。GLP-1 RAs的作用也通过逆概率处理加权(IPTW)和亚组分析进行了研究。结果:GLP-1 RAs组共9795例患者(HF 302例;其他ad组9493例(无HF), 6018例(合并HF 405例;(5613)纳入分析。在有HF病史的患者中,GLP-1 RAs的使用与较低的HHF风险显著相关(HR 0.65;CI 95% 0.426 ~ 0.987);Ci 95% 0.371-0.733)。GLP-1 RAs使用者的全因死亡风险也较低(HF: HR 0.45;Ci 95% 0.320-0.638;无HF: HR 0.44;Ci 95% 0.383-0.514)。IPTW和亚群分析的结果证实了主分析的结果。结论:我们的研究结果显示GLP-1 RAs对HHF和糖尿病患者的全因死亡有益处,无论HF病史如何。尽管我们的研究存在一些局限性,但如果通过专门的随机试验得到证实,这将进一步扩大GLP-1RAs在心血管预防中的作用。”
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
Clinical Research in Cardiology
Clinical Research in Cardiology 医学-心血管系统
CiteScore
11.40
自引率
4.00%
发文量
140
审稿时长
4-8 weeks
期刊介绍: Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.
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