GLP-1RAs and SGLT2is Reduce Cardiovascular Events Independent of Reductions of Systolic Blood Pressure and Body Weight:
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GLP-1RAs and SGLT2is Reduce Cardiovascular Events Independent of Reductions of Systolic Blood Pressure and Body Weight: A Meta-Analysis with MetaRegression Mei Qiu
. Liang-Liang Ding
. Miao Zhang . Jin-Hao Lin .
Xu-Bin Wei . Hua Huang
Received: July 17, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: The impact of reduction of systolic blood pressure or body weight on reduction of cardiovascular events during the treatment with glucagon-like peptide 1 receptor agonists (GLP-1RAs) or sodium-glucose cotransporter 2 inhibitors (SGLT2is) for type 2 diabetes is unclear. Methods: We searched Embase and PubMed. We performed meta-analysis using hazard ratio (HR) and 95% confidence interval (CI) as effect
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12789854. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13300020-00912-z) contains supplementary material, which is available to authorized users. M. Qiu (&) Department of General Medicine, Shenzhen Longhua District Central Hospital, Shenzhen 518110, China e-mail: [email protected] L.-L. Ding Department of Endocrinology, First Affiliated Hospital of Yangtze University, Jingzhou 434000, China M. Zhang Department of Nephrology, Shenzhen Hospital of Beijing University of Chinese Medicine, Shenzhen 518116, China
size stratified by drug class on six endpoints of interest, which were major adverse cardiovascular events (MACE), hospitalization for heart failure (HHF), cardiovascular death (CVD), myocardial infarction (MI), stroke, and all-cause death (ACD). We performed meta-regression to assess the difference between GLP-1RAs and SGLT2is, and the impact of reduction of systolic blood pressure or body weight on reduction of cardiovascular events. Results: We included 11 randomized trials. Compared with placebo, SGLT2is reduced HHF by 32% (HR 0.68, 95% CI 0.60–0.76) whereas GLP-1RAs reduced HHF by only 9% (HR 0.91, 95% CI 0.83–0.99). The benefit from SGLT2is on HHF was significantly greater than that from GLP-1RAs (Psubgroup = 0.004). GLP-1RAs reduced stroke by 16% (HR 0.84, 95% CI 0.76–0.93) whereas SGLT2is did not reduce stroke (HR 0.96, 95% CI 0.82–1.12). GLP-1RAs and SGLT2is J.-H. Lin Department of Gastroenterology, Shenzhen Hospital of Beijing University of Chinese Medicine, Shenzhen 518116, China X.-B. Wei Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, China H. Huang Department of Neurology, Hankou Hospital of Wuhan City, Wuhan 430312, China
Diabetes Ther
similarly reduced MACE by 12%, CVD by 15%, MI by 9%, and ACD by 13%. The effects of systolic blood pressure reduction and body weight reduction on the logarithms of HRs of GLP-1RAs or SGLT2is vs. placebo as for reducing six endpoints of interest were not statistically significant (b ranged from - 0.145 to 0.269, and P ranged from 0.211 to 0.941). Conclusions: GLP-1RAs and SGLT2is lead to similar benefits on MACE, CVD, MI, and ACD in adults with
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