Asian Subpopulations May Exhibit Greater Cardiovascular Benefit from Long-Acting Glucagon-Like Peptide 1 Receptor Agonists: A Meta-Analysis of Cardiovascular Outcome Trials
Diabetes & Metabolism Journal
;
: 410-421, 2019.
Article
in English
| WPRIM
| ID: wpr-763668
ABSTRACT
BACKGROUND:
Based on reported results of three large cardiovascular outcome trials (CVOTs) of glucagon-like peptide 1 receptor agonists (GLP-1 RAs), we aimed to investigate the overall effect of GLP-1 RAs on major adverse cardiovascular events (MACEs) and to identify subpopulations exhibiting the greatest cardiovascular (CV) benefit.METHODS:
Three CVOTs reporting effects of long-acting GLP-1 RAs were included LEADER (liraglutide), SUSTAIN-6 (semaglutide), and EXSCEL (exenatide once weekly). In all studies, the primary endpoint was three-point MACE, comprising CV death, non-fatal myocardial infarction, and non-fatal stroke. Overall effect estimates were calculated as hazard ratios and 95% confidence intervals (CIs) using the random-effects model; subgroup analyses reported in the original studies were similarly analyzed.RESULTS:
Overall, statistically significant risk reductions in MACE and CV death were observed. Subgroup analysis indicated a significant racial difference with respect to CV benefit (P for interaction <0.001), and more substantial risk reductions were observed in subjects of African origin (relative risk [RR], 0.78; 95% CI, 0.60 to 0.99) and in Asians (RR, 0.35; 95% CI, 0.09 to 1.32). However, post hoc analysis (Bonferroni method) revealed that only Asians exhibited a significantly greater CV benefit from treatment, compared with white subjects (P<0.0001).CONCLUSION:
Long-acting GLP-1 RAs reduced risks of MACE and CV deaths in high-risk patients with type 2 diabetes mellitus. Our findings of a particularly effective reduction in CV events with GLP-1 RA in Asian populations merits further exploration and dedicated trials in specific populations.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Cardiovascular Diseases
/
Stroke
/
Asian People
/
Diabetes Mellitus, Type 2
/
Glucagon-Like Peptide 1
/
Incretins
/
Myocardial Infarction
Type of study:
Etiology study
/
Prognostic study
/
Systematic reviews
Limits:
Humans
Language:
English
Journal:
Diabetes & Metabolism Journal
Year:
2019
Type:
Article
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