Gustavo de Oliveira Almeida, Thiago Faraco Nienkötter, Caroline Cristine Almeida Balieiro, Eric Pasqualotto, Júlia Braga Cintra, Henrique Champs Porfírio Carvalho, Ana Laura Soares Silva, Júlia Camargo Kabariti, Bárbara Silvestre Minucci, Edmundo Damiani Bertoli, Camila Mota Guida
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A random-effects model was used to calculate risk ratios (RRs) and mean differences (MDs), with 95% confidence intervals (CIs).</p><h3>Results</h3><p>A total of 13 RCTs were included, with 30,512 patients. Compared with placebo, GLP-1 RAs reduced systolic blood pressure (MD − 4.76 mmHg; 95% CI − 6.03, − 3.50; <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 100%) and diastolic blood pressure (MD − 1.41 mmHg; 95% CI − 2.64, − 0.17; <i>p</i> = 0.03; <i>I</i><sup>2</sup> = 100%). GLP-1 RA significantly reduced the occurrence of myocardial infarction (RR 0.72; 95% CI 0.61, 0.85; <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 0%). There were no significant differences between groups in unstable angina (UA; RR 0.84; 95% CI 0.65, 1.07; <i>p</i> = 0.16; <i>I</i><sup>2</sup> = 0%), stroke (RR 0.91; 95% CI 0.74, 1.12; <i>p</i> = 0.38; <i>I</i><sup>2</sup> = 0%), atrial fibrillation (AF; RR 0.49; 95% CI 0.17, 1.43; <i>p</i> = 0.19; <i>I</i><sup>2</sup> = 22%), and deep vein thrombosis (RR 0.30; 95% CI 0.06, 1.40; <i>p</i> = 0.13; <i>I</i><sup>2</sup> = 0%).</p><h3>Conclusions</h3><p>In patients living with obesity or overweight, GLP-1 RA reduced systolic and diastolic blood pressure and the occurrence of myocardial infarction, with a neutral effect on the occurrence of UA, stroke, AF, and deep vein thrombosis.</p><h3>Registration</h3><p>PROSPERO identifier number CRD42023475226.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"24 4","pages":"509 - 521"},"PeriodicalIF":2.8000,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cardiovascular Benefits of GLP-1 Receptor Agonists in Patients Living with Obesity or Overweight: A Meta-analysis of Randomized Controlled Trials\",\"authors\":\"Gustavo de Oliveira Almeida, Thiago Faraco Nienkötter, Caroline Cristine Almeida Balieiro, Eric Pasqualotto, Júlia Braga Cintra, Henrique Champs Porfírio Carvalho, Ana Laura Soares Silva, Júlia Camargo Kabariti, Bárbara Silvestre Minucci, Edmundo Damiani Bertoli, Camila Mota Guida\",\"doi\":\"10.1007/s40256-024-00647-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>GLP-1 receptor agonists (GLP-1 RAs) have emerged as an effective therapeutic class for weight loss. 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引用次数: 0
摘要
背景：GLP-1 受体激动剂（GLP-1 RAs）已成为一种有效的减肥疗法。然而，这些药物在降低肥胖或超重患者心血管终点方面的疗效尚不明确：我们对肥胖或超重患者使用 GLP-1 RAs 与安慰剂的随机对照试验 (RCT) 进行了系统回顾和荟萃分析。我们检索了 PubMed、Cochrane 和 Embase 数据库。采用随机效应模型计算风险比（RRs）和平均差异（MDs）以及 95% 置信区间（CIs）：结果：共纳入 13 项 RCT，30512 名患者。与安慰剂相比，GLP-1 RA可降低收缩压（MD - 4.76 mmHg; 95% CI - 6.03, - 3.50; p < 0.001; I2 = 100%）和舒张压（MD - 1.41 mmHg; 95% CI - 2.64, - 0.17; p = 0.03; I2 = 100%）。GLP-1 RA能明显降低心肌梗死的发生率（RR 0.72; 95% CI 0.61, 0.85; p < 0.001; I2 = 0%）。在不稳定型心绞痛（UA；RR 0.84；95% CI 0.65，1.07；P = 0.16；I2 = 0%）、中风（RR 0.91；95% CI 0.74，1.12；P = 0.38; I2 = 0%）、心房颤动（AF; RR 0.49; 95% CI 0.17, 1.43; p = 0.19; I2 = 22%）和深静脉血栓（RR 0.30; 95% CI 0.06, 1.40; p = 0.13; I2 = 0%）.结论：结论：在肥胖或超重患者中，GLP-1 RA能降低收缩压和舒张压，减少心肌梗死的发生，对UA、中风、房颤和深静脉血栓的发生没有影响：注册：PROSPERO 识别号 CRD42023475226。
Cardiovascular Benefits of GLP-1 Receptor Agonists in Patients Living with Obesity or Overweight: A Meta-analysis of Randomized Controlled Trials
Background
GLP-1 receptor agonists (GLP-1 RAs) have emerged as an effective therapeutic class for weight loss. However, the efficacy of these agents in reducing cardiovascular endpoints among patients living with obesity or overweight is unclear.
Methods
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing GLP-1 RAs versus placebo in patients with obesity or overweight. We searched PubMed, Cochrane, and Embase databases. A random-effects model was used to calculate risk ratios (RRs) and mean differences (MDs), with 95% confidence intervals (CIs).
Results
A total of 13 RCTs were included, with 30,512 patients. Compared with placebo, GLP-1 RAs reduced systolic blood pressure (MD − 4.76 mmHg; 95% CI − 6.03, − 3.50; p < 0.001; I2 = 100%) and diastolic blood pressure (MD − 1.41 mmHg; 95% CI − 2.64, − 0.17; p = 0.03; I2 = 100%). GLP-1 RA significantly reduced the occurrence of myocardial infarction (RR 0.72; 95% CI 0.61, 0.85; p < 0.001; I2 = 0%). There were no significant differences between groups in unstable angina (UA; RR 0.84; 95% CI 0.65, 1.07; p = 0.16; I2 = 0%), stroke (RR 0.91; 95% CI 0.74, 1.12; p = 0.38; I2 = 0%), atrial fibrillation (AF; RR 0.49; 95% CI 0.17, 1.43; p = 0.19; I2 = 22%), and deep vein thrombosis (RR 0.30; 95% CI 0.06, 1.40; p = 0.13; I2 = 0%).
Conclusions
In patients living with obesity or overweight, GLP-1 RA reduced systolic and diastolic blood pressure and the occurrence of myocardial infarction, with a neutral effect on the occurrence of UA, stroke, AF, and deep vein thrombosis.
期刊介绍：
Promoting rational therapy within the discipline of cardiology, the American Journal of Cardiovascular Drugs covers all aspects of the treatment of cardiovascular disorders, particularly the place in therapy of newer and established agents.
Via a program of reviews and original clinical research articles, the journal addresses major issues relating to treatment of these disorders, including the pharmacology, efficacy and adverse effects of the major classes of drugs; information on newly developed drugs and drug classes; the therapeutic implications of latest research into the aetiology of cardiovascular disorders; and the practical management of specific clinical situations.
The American Journal of Cardiovascular Drugs offers a range of additional enhanced features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by a Key Points summary, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist patients, caregivers and others in understanding important medical advances. The journal also provides the option to include various other types of enhanced features including slide sets, videos and animations. All enhanced features are peer reviewed to the same high standard as the article itself. Peer review is conducted using Editorial Manager®, supported by a database of international experts. This database is shared with other Adis journals.
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