Glucagon‐like peptide 1 receptor agonists in patients with type 2 diabetes with and without chronic heart failure: a meta‐analysis of randomized placebo‐controlled outcome trials - Université de Lorraine Access content directly
Journal Articles Diabetes, Obesity and Metabolism Year : 2023

Glucagon‐like peptide 1 receptor agonists in patients with type 2 diabetes with and without chronic heart failure: a meta‐analysis of randomized placebo‐controlled outcome trials

Abstract

Background: Glucagon-like peptide 1 receptor agonists (GLP1-RA) reduce atherosclerotic events in patients with type 2 diabetes (T2D) and a high cardiovascular risk. The effect of GLP1-RA to reduce heart failure (HF) has been inconsistent across T2D trials, and individual trials were underpowered to assess the effect of GLP1-RA according to HF history. In this meta-analysis we aim to assess the effect of GLP1-RA in patients with and without HF history in stable ambulatory patients with T2D. Methods: Random-effects meta-analysis of placebo-controlled trials. The hazard ratio (HR) and 95% confidence intervals (95%CI) were extracted from the treatment effect estimates of HF subgroup analyses reported in each individual study. The primary outcome was a composite of HF hospitalization or cardiovascular death. Results: A total of 54092 patients with T2D from 7 randomized controlled trials were included, of whom 8460 (16%) had HF history. Compared to placebo, GLP1-RA did not reduce the composite of HF hospitalization or cardiovascular death in patients with HF history: HR 0.96, 95%CI 0.84-1.08, but reduced this outcome in patients without HF history: HR 0.84, 95%CI 0.76-0.92. GLP1-RA did not reduce all-cause death in patients with HF history: HR 0.98, 95%CI 0.86-1.11, but reduced mortality in patients without HF history: HR 0.85, 95%CI 0.79-0.92. GLP1-RA reduced atherosclerotic events regardless of HF history: HR 0.85, 95%CI 0.75-0.97 with HF, and HR 0.88, 95%CI 0.83-0.93 without HF. Conclusions: Treatment with GLP1-RA did not reduce HF hospitalizations and mortality in patients with concomitant T2D and HF, but may prevent new-onset HF and mortality in patients with T2D without HF. The reduction of atherosclerotic events with GLP1-RA was not influenced by HF history status. This article is protected by copyright. All rights reserved.
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Dates and versions

hal-03971158 , version 1 (03-02-2023)

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João Pedro Ferreira, Francisca Saraiva, Abhinav Sharma, Francisco Vasques-Nóvoa, António Angélico-Gonçalves, et al.. Glucagon‐like peptide 1 receptor agonists in patients with type 2 diabetes with and without chronic heart failure: a meta‐analysis of randomized placebo‐controlled outcome trials. Diabetes, Obesity and Metabolism, 2023, 25 (6), pp.1495-1502. ⟨10.1111/dom.14997⟩. ⟨hal-03971158⟩
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