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GLP-1 Receptor Agonists and Cardiovascular Disease: a Meta-Analysis of Recent Cardiac Outcome Trials

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Abstract

Purpose

The aim of this study is to examine the cardioprotective properties of Glucagon-like peptide-1 receptor agonist, a class of antihyperglycemic therapy, via meta-analysis of four recently published cardiovascular outcomes trials.

Methods

Meta-analysis was performed pooling data from the ELIXA, LEADER, SUSTAIN-6 and EXSCEL trials. A random effects model was used to generate risk ratio with 95% confidence interval for cardiovascular and safety outcomes.

Results

A total of 33,457 patients were included in the meta-analysis. Based on the study, GLP-1R agonists significantly reduced all-cause mortality (RR 0.89; 95% CI 0.82 to 0.96) and cardiovascular mortality (RR 0.88; 95% CI 0.80 to 0.97) when compared to placebo. When long-acting agents were analyzed alone, reduction in major adverse cardiac events (RR 0.88; 95% CI 0.81 to 0.97) and non-fatal strokes (RR 0.87; 95% CI 0.76 to 0.99) also showed significance.

Conclusion

Overall, GLP-1R agonists appear to have cardioprotective properties likely via modification of metabolic parameters such as glycemic control, weight loss, and improvement in blood pressure. Additional studies are warranted to compare cardiovascular outcomes among the different agents.

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Authors and Affiliations

  1. The Section of Cardiology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA

    Xiaoming Jia, Mahboob Alam & Yochai Birnbaum

  2. The Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA

    Yumei Ye

  3. Endocrinology and Diabetes Division, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Mandeep Bajaj

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  1. Xiaoming Jia
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  2. Mahboob Alam
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  3. Yumei Ye
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  5. Yochai Birnbaum
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Correspondence to Xiaoming Jia.

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Conflict of Interest

Yochai Birnbaum has received research grants from AstraZeneca, Boehringer Ingelheim. He has received lecture fees from Daiichi Sankyo and AstraZeneca. Yumei Ye has received research grants from AstraZeneca, Boehringer Ingelheim. Author Mandeep Bajaj has received research grants from Amylin, AstraZeneca, Boehringer Ingelheim, Eli-Lilly, Sanofi Aventis, and Novo Nordisk. Xiaoming Jia declares he has no conflicts of interest. Mahboob Alam declares he no conflicts of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Jia, X., Alam, M., Ye, Y. et al. GLP-1 Receptor Agonists and Cardiovascular Disease: a Meta-Analysis of Recent Cardiac Outcome Trials. Cardiovasc Drugs Ther 32, 65–72 (2018). https://doi.org/10.1007/s10557-018-6773-2

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