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- Title
Effects of glucagon‐like peptide‐1 receptor agonists on cardiovascular and renal outcomes: A meta‐analysis and meta‐regression analysis.
- Authors
Yoshiji, Satoshi; Minamino, Hiroto; Tanaka, Daisuke; Yamane, Shunsuke; Harada, Norio; Inagaki, Nobuya
- Abstract
Aim: To evaluate the cardiovascular and renal outcomes of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) and the associations between these outcomes and HbA1c or weight reduction. Materials and Methods: We searched PubMed/MEDLINE, EMBASE, and CENTRAL databases for randomized, placebo‐controlled trials of GLP‐1 RAs reporting major adverse cardiovascular events (MACE; a composite of cardiovascular mortality, stroke, and myocardial infarction) as the primary outcome. We conducted a meta‐regression analysis of primary and secondary outcomes with HbA1c or weight reduction following a meta‐analysis with a random‐effects model for these outcomes. Results: We extracted data of 60 800 individuals from eight eligible studies (ELIXA, LEADER, SUSTAIN‐6, EXSCEL, HARMONY, PIONEER 6, REWIND, and AMPLITUDE‐O). GLP‐1 RAs reduced MACE (hazard ratio [HR] 0.86; 95% CI: 0.80‐0.93; P <.001) and secondary outcomes including the composite renal outcome (0.80; 0.73‐0.87; P <.001). In meta‐regression analysis, every 1% reduction in HbA1c was associated with 26% and 35% decreases in the logarithm of HR of MACE (P =.044; R2 = 0.65) and the composite renal outcome (P =.040; R2 = 0.85), respectively. On the contrary, weight reduction was not associated with any outcome, including MACE (P =.390). Conclusions: The reduction in HbA1c, but not body weight, is associated with cardiovascular and renal outcomes. The magnitude of HbA1c reduction can be a surrogate for the cardiovascular and renal benefits of treatment with GLP‐1 RAs.
- Subjects
GLUCAGON-like peptide-1 receptor; GLUCAGON-like peptide-1 agonists; MAJOR adverse cardiovascular events; META-analysis
- Publication
Diabetes, Obesity & Metabolism, 2022, Vol 24, Issue 6, p1029
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/dom.14666