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Glucagon-like peptide-1 receptor agonists and heart failure in type 2 diabetes: systematic review and meta-analysis of randomized and observational studies

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dc.contributor.author Li, Ling
dc.contributor.author Li, Sheyu
dc.contributor.author Liu, Jiali
dc.contributor.author Deng, Ke
dc.contributor.author Busse, Jason-W.
dc.contributor.author Vandvik, Per-Olav
dc.contributor.author Wong, Evelyn
dc.contributor.author Sohani, Zahra-N.
dc.contributor.author Bala, Malgorzata-M.
dc.contributor.author Rios, Lorena-P.
dc.contributor.author Malaga, German
dc.contributor.author Ebrahim, Shanil
dc.contributor.author Shen, Jiantong
dc.contributor.author Zhang, Longhao
dc.contributor.author Zhao, Pujing
dc.contributor.author Chen, Qunfei
dc.contributor.author Wang, Yingqiang
dc.contributor.author Guyatt, Gordon-H.
dc.contributor.author Sun, Xin
dc.date.accessioned 2019-02-06T14:45:36Z
dc.date.available 2019-02-06T14:45:36Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5101
dc.description.abstract BACKGROUND: The effect of glucagon-like peptide-1(GLP-1) receptor agonists on heart failure remains uncertain. We therefore conducted a systematic review to assess the possible impact of GLP-1 agonists on heart failure or hospitalization for heart failure in patients with type 2 diabetes. METHODS: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov to identify randomized controlled trials (RCTs) and observational studies that addressed the effect of GLP-1 receptor agonists in adults with type 2 diabetes, and explicitly reported heart failure or hospitalization for heart failure. Two paired reviewers screened reports, collected data, and assessed the risk of bias. We pooled data from RCTs and observational studies separately, and used the GRADE approach to rate the quality of evidence. RESULTS: We identified 25 studies that were eligible for our review; 21 RCTs (n = 18,270) and 4 observational studies (n = 111,029). Low quality evidence from 20 RCTs suggested, if anything, a lower incidence of heart failure between GLP-1 agonists versus control (17/7,441 vs. 19/4,317; odds ratio (OR) 0.62, 95 % confidence interval (CI) 0.31 to 1.22; risk difference (RD) 19 fewer, 95 % CI 34 fewer to 11 more per 1000 over 5 years). Three cohort studies comparing GLP-1 agonists to alternative agents provided very low quality evidence that GLP-1 agonists do not increase the incidence of heart failure. One RCT provided moderate quality evidence that GLP-1 agonists were not associated with hospitalization for heart failure (lixisenatide vs placebo: 122/3,034 vs. 127/3,034; adjusted hazard ratio 0.96, 95 % CI 0.75 to 1.23; RD 4 fewer, 95 % CI 25 fewer to 23 more per 1000 over 5 years) and a case-control study provided very low quality evidence also suggesting no association (GLP-1 agonists vs. other anti-hyperglycemic drugs: 1118 cases and 17,626 controls, adjusted OR 0.67, 95 % CI 0.32 to 1.42). CONCLUSIONS: The current evidence suggests that GLP-1 agonists do not increase the risk of heart failure or hospitalization for heart failure among patients with type 2 diabetes. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartof urn:issn:1471-2317
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Animals en_US
dc.subject Chi-Square Distribution en_US
dc.subject Diabetes Mellitus, Type 2/complications/diagnosis/drug therapy/mortality en_US
dc.subject Glucagon-like peptide-1 receptor en_US
dc.subject Glucagon-Like Peptide-1 Receptor/agonists/metabolism en_US
dc.subject Heart failure en_US
dc.subject Heart Failure/diagnosis/etiology/mortality en_US
dc.subject Hospitalization en_US
dc.subject Humans en_US
dc.subject Hypoglycemic Agents/adverse effects/therapeutic use en_US
dc.subject Meta-analysis en_US
dc.subject Observational Studies as Topic en_US
dc.subject Odds Ratio en_US
dc.subject Randomized Controlled Trials as Topic en_US
dc.subject Risk Assessment en_US
dc.subject Risk Factors en_US
dc.subject Systematic review en_US
dc.subject Time Factors en_US
dc.subject Treatment Outcome en_US
dc.subject Type 2 diabetes en_US
dc.title Glucagon-like peptide-1 receptor agonists and heart failure in type 2 diabetes: systematic review and meta-analysis of randomized and observational studies en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12872-016-0260-0
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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