Canagliflozin for Prevention of Cardiovascular and Renal Outcomes in type2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Canagliflozin for Prevention of Cardiovascular and Renal Outcomes in type2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
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卡格列净预防 2 型糖尿病心血管和肾脏结局：随机对照试验的系统回顾和荟萃分析
DOI：
10.3389/fphar.2021.691878
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发表时间：
2021
影响因子：
5.6
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Tian L;Cai Y;Zheng H;Ai S;Zhou M;Luo Q;Tang J;Liu W;Wang Y
目的：我们旨在通过系统性综述和荟萃分析评价卡格列净治疗2型糖尿病（T2 DM）患者特定心血管和肾脏结局的疗效。研究方法：我们对PubMed、科克伦图书馆和Embase进行了全面检索，以查找截至2020年9月28日发表的关于卡格列净治疗T2 DM的随机、安慰剂对照试验。记录的心血管结局包括心血管死亡率、心力衰竭、心肌梗死和卒中。记录的肾脏复合结局为终末期肾病（ESRD）、肾性死亡。汇总主要心血管结局、ESRD和肾性死亡的数据，并表示为风险比（HR）和95%置信区间（CI）。两名评审员独立选择试验并提取数据。结果：我们共识别出1，741篇出版物，留下96篇进行标题、摘要和全文综述。其中，10项试验符合纳入标准，并最终纳入我们的荟萃分析。荟萃分析显示，卡格列净可显著降低T2 DM患者心力衰竭风险36%（HR 0.64，95% CI 0.53 - 0.77，p = 0.000）。卡格列净对非致死性心肌梗死或非致死性卒中的影响（HR 0.84，95% CI：0.76至0.93，p = 0.001），心血管死亡率T2 DM患者中的风险（HR 0.84，95% CI 0.72 - 0.97，p = 0.021）和心肌梗死（HR 0.84，95% CI 0.70 - 1.00，p = 0.045）相对较小，风险降低16%。此外，卡格列净使T2 DM患者的卒中风险降低13%（HR 0.87，95% CI 0.71 - 1.06，p = 0.166）。此外，卡格列净使ESRD或肾死亡复合肾脏事件的风险显著降低36%（HR 0.64，95% CI 0.54 - 0.75，p = 0.000）。结论：这项荟萃分析表明，卡格列净可保护T2 DM患者的心血管和肾脏结局。系统性综述注册：[https：//www.crd.york.ac.uk/pagio]，标识符[CRD 42020210315]
Objective: We aimed to evaluate the efficacy of canagliflozin for the treatment of specific cardiovascular and renal outcomes in Type 2 diabetes mellitus (T2DM) patients by means of a systematic review and meta-analysis. Methods: We performed comprehensive searches of PubMed, the Cochrane Library, and Embase for randomized, placebo-controlled trials of the treatment of T2DM with canagliflozin that were published to 28 September 2020. The cardiovascular outcomes recorded were cardiovascular mortality, heart failure, myocardial infarction, and stroke. The renal composite outcomes recorded were end-stage renal disease (ESRD), renal death. The data for the principal cardiovascular outcomes, ESRD, and renal death were pooled and expressed as Hazard ratios (HRs) with 95% confidence intervals (CIs). Two reviewers independently selected the trials and extracted the data. Results: We identified a total of 1,741 publications, leaving 96 for their titles, abstracts and full-text review. Of these, 10 trials met the inclusion criteria and were finally included in our meta-analysis. The meta-analysis showed that canagliflozin significantly reduced the risk of heart failure in T2DM by 36% (HR 0.64, 95% CI 0.53 to 0.77, p = 0.000). The effects of canagliflozin on non-fatal myocardial infarction or non-fatal stroke (HR 0.84, 95% CI: 0.76 to 0.93, p = 0.001), cardiovascular mortality (HR 0.84, 95% CI 0.72 to 0.97, p = 0.021), and myocardial infarction (HR 0.84, 95% CI 0.70 to 1.00, p = 0.045) in patients with T2DM were relatively small, reducing the risks by 16%. In addition, canagliflozin reduced the risk of stroke in T2DM patients by 13% (HR 0.87, 95% CI 0.71 to 1.06, p = 0.166). Moreover, canagliflozin significantly reduced the risk of the composite renal event of ESRD or renal death by 36% (HR 0.64, 95% CI 0.54 to 0.75, p = 0.000). Conclusion: This meta-analysis suggests that canagliflozin protects against cardiovascular and renal outcomes in patients with T2DM. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero], identifier [CRD42020210315]
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影响因子：
3
作者：
Qiu R;Capuano G;Meininger G
通讯作者：
Meininger G
影响因子：
8.2
作者：
Lavalle-Gonzalez, F. J.;Januszewicz, A.;Davidson, J.;Tong, C.;Qiu, R.;Canovatchel, W.;Meininger, G.
通讯作者：
Meininger, G.
影响因子：
16.2
作者：
Leiter, Lawrence A.;Yoon, Kun-Ho;Meininger, Gary
通讯作者：
Meininger, Gary
影响因子：
158.5
作者：
Perkovic, V.;Jardine, M. J.;Bentley-Lewis, Rhonda
通讯作者：
Bentley-Lewis, Rhonda
影响因子：
44.5
作者：
Barnett, Anthony H.;Mithal, Ambrish;Broedl, Uli C.
通讯作者：
Broedl, Uli C.