Ethnic Variations in Cardiovascular and Renal Outcomes From Newer Glucose-Lowering Drugs: A Meta-Analysis of Randomized Outcome Trials.
Ethnic Variations in Cardiovascular and Renal Outcomes From Newer Glucose-Lowering Drugs: A Meta-Analysis of Randomized Outcome Trials.
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DOI：
10.1161/jaha.122.026791
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发表时间：
2023-05-16
影响因子：
5.4
通讯作者：
Guo, Jingchuan
中科院分区：
文献类型：
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作者：
Tang, Huilin;Chen, Weihan;Bian, Jiang;O'Neal, LaToya J. J.;Lackland, Daniel T. T.;Schatz, Desmond A. A.;Guo, Jingchuan
西班牙裔人群比非西班牙裔白人更容易患糖尿病及其相关疾病。很少有证据支持钠-葡萄糖共转运蛋白2抑制剂和胰高血糖素样肽- 1受体激动剂对心血管和肾脏的益处是否适用于西班牙裔人群。我们纳入了心血管和肾脏结局试验（截至2021年3月），这些试验报告了2型糖尿病（T2D）患者的主要不良心血管事件（mace）、心血管死亡/心力衰竭住院和复合肾脏结局，使用固定效应模型计算了95% ci的合并风险比（hr），并测试了西班牙裔和非西班牙裔人群之间的差异（P为相互作用[P相互作用]）。在3项钠-葡萄糖共转运蛋白2抑制剂试验中，西班牙裔（HR, 0.70 [95% CI, 0.54-0.91]）和非西班牙裔（HR, 0.96 [95% CI, 0.86-1.07]）组在MACE风险方面的治疗效果（P相互作用=0.03）存在统计学显著差异，但心血管死亡/心力衰竭住院风险（P相互作用=0.46）和复合肾脏结局（P相互作用=0.31）除外。在5项胰高血糖素样肽- 1受体激动剂试验中，西班牙裔人群（HR, 0.82 [95% CI, 0.70-0.96]）和非西班牙裔人群（HR, 0.92 [95% CI, 0.84-1.00]）的治疗效果对MACE风险的影响无统计学差异（相互作用P =0.22）。在3项二肽基肽酶- 4抑制剂试验中，西班牙裔人群MACE风险的HR （HR, 1.15 [95% CI, 0.98-1.35]）高于非西班牙裔人群（HR, 0.96 [95% CI, 0.88-1.04]）（相互作用P =0.045）。与非西班牙裔患者相比，西班牙裔T2D患者在使用钠-葡萄糖共转运蛋白2抑制剂降低MACE风险方面获益更大。
Hispanic populations are more likely to develop diabetes and its related diseases than non‐Hispanic White populations. Little evidence exists to support whether the cardiovascular and renal benefits of sodium‐glucose cotransporter 2 inhibitors and glucagon‐like peptide‐1 receptor agonists are generalizable to the Hispanic populations. We included the cardiovascular and renal outcome trials (up to March 2021) that reported the major adverse cardiovascular events (MACEs), cardiovascular death/hospitalization for heart failure, and composite renal outcomes by ethnicity in individuals with type 2 diabetes (T2D), calculated pooled hazard ratios (HRs) with 95% CIs using fixed‐effects models, and tested the differences between Hispanic and non‐Hispanic populations (P for interaction [P interaction]). In 3 sodium‐glucose cotransporter 2 inhibitor trials, there was a statistically significant difference between Hispanic (HR, 0.70 [95% CI, 0.54–0.91]) and non‐Hispanic (HR, 0.96 [95% CI, 0.86–1.07]) groups in treatment effects on MACE risk (P interaction=0.03), except for risks of cardiovascular death/hospitalization for heart failure (P interaction=0.46) and composite renal outcome (P interaction=0.31). In 5 glucagon‐like peptide‐1 receptor agonist trials, there was no statistically significant difference in treatment effect on MACE risk between Hispanic (HR, 0.82 [95% CI, 0.70–0.96]) and non‐Hispanic (HR, 0.92 [95% CI, 0.84–1.00]) populations (P interaction=0.22). In 3 dipeptidyl peptidase‐4 inhibitor trials, the HR for MACE risk appeared greater in Hispanic (HR, 1.15 [95% CI, 0.98–1.35]) than non‐Hispanic (HR, 0.96 [95% CI, 0.88–1.04]) populations (P interaction=0.045). Compared with non‐Hispanic individuals, Hispanic individuals with T2D appeared to obtain a greater benefit of lowered MACE risk with sodium‐glucose cotransporter 2 inhibitors.