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Cited by 65Diabetes Treatment and ManagementHeart Failure Treatment and ManagementCardiovascular Function and Risk Factors

Glucagon-like peptide 1 receptor agonists in patients with type 2 diabetes with and without chronic heart failure: a meta-analysis of randomized placebo-controlled outcome trials

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Ferreira, João Pedro, Saraiva, Francisca, Sharma, Abhinav, Vasques‐Nóvoa, Francisco, Angélico‐Gonçalves, António, Leite, Ana Rita, Borges‐Canha, Marta, Carvalho, Davide +4 more·2023·Diabetes, Obesity and Metabolism
DOI 10.1111/dom.14997
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Abstract

Aim: Glucagon‐like peptide 1 receptor agonists (GLP1‐RA) reduce atherosclerotic events in patients with type 2 diabetes (T2D) and a high cardiovascular risk. The effect of GLP1‐RA to reduce heart failure (HF) has been inconsistent across T2D trials, and individual trials were underpowered to assess the effect of GLP1‐RA according to HF history. In this meta‐analysis we aim to assess the effect of GLP1‐RA in patients with and without HF history in stable ambulatory patients with T2D. Methods: Random‐effects meta‐analysis of placebo‐controlled trials. The hazard ratio (HR) and 95% confidence intervals (95% CI) were extracted from the treatment effect estimates of HF subgroup analyses reported in each individual study. The primary outcome was a composite of HF hospitalization or cardiovascular death. Results: In total, 54 092 patients with T2D from seven randomized controlled trials were included, of whom 8460 (16%) had HF history. Compared with placebo, GLP1‐RA did not reduce the composite of HF hospitalization or cardiovascular death in patients with HF history: HR 0.96, 95% CI: 0.84‐1.08, but reduced this outcome in patients without HF history: HR 0.84, 95% CI: 0.76‐0.92. GLP1‐RA did not reduce all‐cause death in patients with HF history: HR 0.98, 95% CI: 0.86‐1.11, but reduced mortality in patients without HF history: HR 0.85, 95% CI: 0.79‐0.92. GLP1‐RA reduced atherosclerotic events regardless of HF history: HR 0.85, 95% CI: 0.75‐0.97 with HF, and HR 0.88, 95% CI: 0.83‐0.93 without HF. Conclusions: Treatment with GLP1‐RA did not reduce HF hospitalizations and mortality in patients with concomitant T2D and HF, but may prevent new‐onset HF and mortality in patients with T2D without HF. The reduction of atherosclerotic events with GLP1‐RA was not influenced by HF history status.

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  • The cardiovascular outcome trials with GLP-1 receptor agonists have generally shown protective effects against major adverse cardiovascular events, but different members of the class have exerted different effects on cardiovascular deaths, non-fatal myocardial infarction and non-fatal stroke as well as improving heart failure prognosis in some studies.

    “The 'cardiovascular outcome trials' with GLP1RAs have generally shown protective effects against major adverse cardiovascular events, but different members of the class have exerted different effects on CV deaths, non-fatal myocardial infarction and non-fatal stroke as well as improving heart failure prognosis in some studies [72-74].”

    From Recent advances in peptide-based therapies for obesity and type 2 diabetes (2024) · cites this paper as [74]

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Authors
Ferreira, J. P., Saraiva, F., Sharma, A., Vasques‐Nóvoa, F., Angélico‐Gonçalves, A., Leite, A. R., Borges‐Canha, M., Carvalho, D., Packer, M., Zannad, F., Leite‐Moreira, A., & Neves, J. S.
Affiliations
  • Inserm (FR)
  • Universidade do Porto (PT)
  • McGill University Health Centre (CA)
  • Baylor University Medical Center (US)
  • Cardiovascular R&D Centre—UnIC@RISE, Department of Surgery and Physiology Faculty of Medicine of the University of Porto Porto Portugal
Corresponding author
  • Ferreira, João Pedro
  • Neves, João Sérgio
ORCID
Venue
Diabetes, Obesity and Metabolism
Publisher
Wiley
Published
2023-02-20
Volume
25
Issue
6
Pages
1495-1502
ISSN
  • 1462-8902 (ISSN-L)
  • 1463-1326
DOI
10.1111/dom.14997
OpenAlex
W4318754175
Cited by
65
References
31
Citations by year
2026: 10 · 2025: 19 · 2024: 29 · 2023: 7
FWCI
2.35
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Diabetes Obesity and Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, other-oa)
Funders
Fundação para a Ciência e a Tecnologia (UIDB/00051/2020, LA/P/0053/2020, UIDP/00051/2020)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
GLP-1 receptor agonists, type 2 diabetes, chronic heart failure, heart failure hospitalization, cardiovascular mortality, all-cause mortality, atherosclerotic events, new-onset heart failure, subgroup analysis, cardiovascular risk
MeSH terms
Cardiovascular System, Diabetes Mellitus, Type 2, Heart Failure, Humans, Hypoglycemic Agents, Randomized Controlled Trials as Topic, Atherosclerosis, Glucagon-Like Peptide 1

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