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Glucagon-like Peptide-1 Receptor Agonists Cardio-protective Effects: An Umbrella Review

Asim Ahmed Elnour1, Noora Al Hajri2, Israa Yousif El Khidir3

  • 1College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates.

Current Diabetes Reviews
|May 23, 2020
PubMed
Abstract

Insights

Glucagon-Like Peptide-One Receptor Agonists (GLP-1 RAs) show clear cardioprotective effects in diabetes patients with varying cardiovascular risk. However, evidence for those with high cardiovascular risk or existing heart disease is limited, suggesting personalized treatment approaches are needed.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Focus on the cardioprotective effects of Glucagon-Like Peptide-One Receptor Agonists (GLP-1 RAs).
  • Investigating the role of GLP-1 RAs in reducing cardiovascular risk in type 2 diabetes mellitus patients.

Purpose of the Study:

  • Critically appraise seven meta-analyses of randomized clinical trials (RCTs) on GLP-1 RAs in diabetes.
  • Evaluate the primary outcome of major cardiovascular events associated with GLP-1 RA use.

Main Methods:

  • Systematic review and critical appraisal of seven meta-analyses.
  • Analysis based on PICO: 138,750 participants, GLP-1 RA intervention, placebo comparator, major cardiovascular events outcome.

Main Results:

  • Overall evidence supports GLP-1 RAs' cardioprotective effect in diabetes patients across various cardiovascular risk levels.
  • Most meta-analyses did not demonstrate significant cardioprotection in high-risk diabetes patients or those with pre-existing cardiovascular disease.
  • Patient variability and drug potency are crucial for successful GLP-1 RA selection.

Conclusions:

  • Future RCTs for GLP-1 RAs in diabetes should stratify participants by cardiovascular risk (high, moderate, low) and history of cardiovascular disease.
  • Subgroup analyses are essential to understand differential effects of GLP-1 RAs based on patient characteristics.
Keywords:
Cardiovascular Diseases (CVD)Glucagon-like Peptide 1 Receptor Agonist (GLP-1 RA)Major Adverse Cardiovascular Events (MACE)Type 2 Diabetes Mellitus (T2DM)meta-analysis

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