胰高血糖素样肽-1 受体激动剂对预防糖尿病患者和非糖尿病患者中风的疗效：SELECT 和 FLOW 试验的荟萃分析

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-03-16 DOI:10.1016/j.ijcha.2025.101638

Asmita Gera , Fakhar Latif , Vamsikalyan Borra , Sidra Naz , Vivek Mittal , Fathima Shehnaz Ayoobkhan , Tushar Kumar , Zarghoona Wajid , Novonil Deb , Tanisha Prasad , Jishanth Mattumpuram , Vikash Jaiswal

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引用次数: 0

摘要

背景胰高血糖素样肽-1 受体激动剂（GLP-1 RAs）可减少 2 型糖尿病（T2DM）患者的主要不良心血管事件（MACE）。方法我们在 PubMed、EMBASE 和 ClinicalTrials.gov 上进行了系统的文献检索，检索了从检查到 2024 年 7 月 15 日的相关随机对照试验 (RCT)，没有任何语言限制。采用随机效应模型汇总了患病率比（OR）和95%置信区间（CI），P值为< 0.05被认为具有统计学意义。结果共有11项RCT、85,373名患者被纳入分析（GLP-1 RA组43,339人，安慰剂组42,034人）。GLP-1 RA组和安慰剂组患者的平均年龄分别为63.5岁和63.1岁。对主要终点和次要终点的汇总分析显示，与安慰剂相比，GLP-1 RAs 可显著降低中风发病风险 15%（OR，0.85（95 %CI：0.77-0.93），P < 0.001）和非致命性中风风险 13%（OR，0.87（95 %CI：0.79-0.95），P < 0.001）。不过，两组患者发生致命中风的风险（OR，0.94（95 %CI：0.75-1.17），P = 0.56）相当。同样，脑血管意外（OR，0.75（95 %CI：0.57-1.00），P = 0.05）、出血性中风（OR，0.82（95 %CI：0.42-1.60），P = 0.57）和缺血性中风（OR，0.85（95 %CI：0.结论使用 GLP-1 受体激动剂治疗对降低糖尿病患者和非糖尿病患者的中风和非致命性中风风险均有益处。结论GLP-1 受体激动剂对降低糖尿病患者和非糖尿病患者的中风风险和非致命性中风风险均有益处，但对致命性中风则无影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Efficacy of glucagon-like peptide-1 receptor agonists for prevention of stroke among patients with and without diabetes: A meta-analysis with the SELECT and FLOW trails

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Efficacy of glucagon-like peptide-1 receptor agonists for prevention of stroke among patients with and without diabetes: A meta-analysis with the SELECT and FLOW trails

Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown a reduction in major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). However, its efficacy on cerebrovascular events is yet to be well established among diabetic and non diabetic patients.

Objective

We sought to evaluate the efficacy of GLP-1 RAs on stroke risk among its different types in patients with and without Diabetes.

Methods

We performed a systematic literature search on PubMed, EMBASE, and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) from inspection until 15th July 2024, without any language restrictions. Odds ratios (OR) and 95 % confidence intervals (CI) were pooled using a random-effect model, and a p-value of < 0.05 was considered statistically significant.

Results

A total of 11 RCTs with 85,373 patients were included (43,339 in GLP-1 RA and 42,034 in the placebo group) in the analysis. The mean age of the patients in GLP-1 RAs and the placebo groups was 63.5 and 63.1 years, respectively. Pooled analysis of primary and secondary endpoints showed that GLP-1 RAs significantly reduced the risk of incidence of stroke by 15 % (OR, 0.85(95 %CI: 0.77–0.93), P < 0.001) and nonfatal stroke by 13 % (OR, 0.87(95 %CI: 0.79–0.95), P < 0.001) compared with placebo. However, the risk of fatal stroke (OR, 0.94(95 %CI: 0.75–1.17), P = 0.56) was comparable between both groups of patients. Similarly, the risk of serious adverse events such as cerebrovascular accident (OR, 0.75(95 %CI: 0.57–1.00), P = 0.05), hemorrhagic stroke (OR, 0.82(95 %CI: 0.42–1.60), P = 0.57, and ischemic stroke (OR, 0.85(95 %CI: 0.64–1.13), P = 0.26) was comparable between GLP-1RAs and placebo.

Conclusion

Treatment with GLP-1 receptor agonists has beneficial effects in reducing the risk of stroke, and nonfatal stroke in patients with and without diabetes. However, no such effect was observed for fatal stroke.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.