The Effects Of The Baseline Characteristics On The Efficacy Of Glp-1 Ras In Reducing Cardiovascular Events In Type 2 Diabetes: A Meta-Analysis

Background: Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have been proven to be able to significantly reduce major adverse cardiovascular events (MACE) in type 2 diabetic adults. However, the effects of GLP-1 RAs on MACE in many diabetic subgroups are unestablished. Methods: PubMed and Embase were searched for relevant trials. We conducted a random-effects meta-analysis on MACE in various subgroups defined by seven factors (i.e., sex, duration of diabetes, history of heart failure, prior myocardial infarction or stroke, antihyperglycemic oral agent therapy, insulin therapy, and DPP-4 inhibitor therapy) to synthesize a hazard ratio (HR). A meta-regression was performed to calculate P-subgroup (the P value for subgroup differences). Results: We included seven trials in our analysis. GLP-1 RAs significantly reduced the risk of MACE (HR 0.88, 95% CI 0.83-0.93) in type 2 diabetic adults and significantly reduced this risk in most diabetic subgroups of interest (the HR ranged from 0.77 to 0.89). The relative reductions in the risk of MACE exhibited by the GLP-1 RAs were consistent across the various diabetic subgroups defined by the seven factors of interest (the P-subgroup ranged from 0.220 to 0.711). Conclusions: GLP-1 RAs can significantly reduce the risk of MACE in type 2 diabetes regardless of sex, duration of diabetes, history of heart failure, prior myocardial infarction or stroke, or the baseline use of oral antihyperglycemic agents or insulin.