Opportunities of Antidiabetic Drugs in Cardiovascular Medicine A Meta-Analysis and Perspectives for Trial Design
Opportunities of Antidiabetic Drugs in Cardiovascular Medicine A Meta-Analysis and Perspectives for Trial Design
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抗糖尿病药物在心血管医学中的机会荟萃分析和试验设计展望
DOI：
10.1161/hypertensionaha.120.14791
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发表时间：
2020-08-01
期刊：
影响因子：
8.3
通讯作者：
Feng, Ying-Mei
中科院分区：
文献类型：
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作者：
Yan, Cen;Thijs, Lutgarde;Feng, Ying-Mei
为了确定 GLP1-RA（胰高血糖素样肽 1 受体激动剂）和 SGLT2-Is（钠依赖性葡萄糖协同转运蛋白 2 抑制剂）在心血管医学中的潜在应用，我们进行了截至 2020 年 3 月 31 日的 PubMed 检索，并选择了针对 2 型糖尿病患者的安慰剂对照随机试验 (RCT)。使用随机效应模型汇总了随机对照试验中的 24 小时动态血压和诊室血压 (BP)、主要不良心血管事件 (MACE)、慢性肾病 (CKD) 的进展以及糖化血红蛋白和体重的变化。在 2238 名患者（7 个 RCT）中，SGLT2-Is 将 24 小时收缩压/舒张压降低了 4.4/1.9 mm Hg（95% CI，3.4-5.5/1.2-2.6 mm Hg），而 2 个 GLP1-RA RCT 产生了矛盾的血压结果。对 56 004 名患者（7 个随机对照试验）进行了超过 1.3 至 5.4 年的随访，与 GLP1-RA 治疗相关的 MACE 总风险比为 0.88（0.84-0.93），CKD 为 0.84（0.74-0.89），各个 MACE 终点的范围为 0.84 至 0.90（P
To identify potential application of GLP1-RAs (glucagon-like peptide-1 receptor agonists) and SGLT2-Is (sodium-dependent glucose cotrasnsporter-2 inhibitors) in cardiovascular medicine, we performed PubMed search until March 31, 2020 and selected placebo-controlled randomized trials (RCTs) in patients with type 2 diabetes mellitus. Twenty-four hour ambulatory and office blood pressure (BP), major adverse cardiovascular events (MACE), progression of chronic kidney disease (CKD), and changes in glycated hemoglobin and body weight were aggregated across RCTs using random-effect models. In 2238 patients (7 RCTs), SGLT2-Is lowered 24-hour systolic/diastolic BP by 4.4/1.9 mm Hg (95% CI, 3.4-5.5/1.2-2.6 mm Hg), whereas 2 GLP1-RAs RCTs produced contradictory BP results. Over 1.3 to 5.4 years of follow-up of 56 004 patients (7 RCTs), aggregate hazard ratios associated with GLP1-RA treatment were 0.88 (0.84-0.93) for MACE, 0.84 (0.74-0.89) for CKD, and ranged from 0.84 to 0.90 for individual MACE end points (P