Effects of glucagon-like peptide-1 receptor agonists on major coronary events in patients with type 2 diabetes.

AIMS: In patients suffering from type 2 diabetes mellitus (T2DM), the effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) treatment on major coronary events, including myocardial infarction (MI), unstable angina and coronary revascularization, is unclear. We performed a meta-analysis to assess the benefits of GLP-1RAs for major coronary events. MATERIALS AND METHODS: We systematically searched the PubMed, CENTRAL, EMBASE, and clinicaltrial.gov databases to seek eligible studies with a cardiovascular endpoint comparing GLP-1RAs with a placebo in T2DM patients. Odds ratio (OR) and 95% confidence interval (CI) were calculated for the outcomes. RESULTS: Nine studies, with a total of 64236 patients, were conducted. GLP-1RA treatment reduced fatal and non-fatal MI by 8% (OR 0.92, 95% CI 0.86-0.99; P = 0.02; I2 = 39%). Further, the reduction reached 15% in human-based GLP-1RA treated patients. Similarly, Once-weekly GLP-1RA treatment reduced the risk of MI by 13%. In contrast, GLP-1RA treatment did not reduce the risk of hospitalization for unstable angina (OR 1.11, 95% CI 0.97-1.28; P = 0.13; I2 = 21%). GLP-1RAs exhibited a tendency to lower the risk of coronary revascularization (OR 0.95, 95% CI 0.89-1.02，P = 0.15，I2 = 22%), but without statistical significance. However, human-based GLP-1RAs decreased the risk by 11%. CONCLUSIONS: In high-risk patients suffering from T2DM, GLP-1RAs were associated with a decrease in MI, especially the human-based and once-weekly GLP-1RAs. No benefit was seen for hospitalization for unstable angina or coronary revascularization. Further research is urgently needed to ascertain improvements in coronary events. This article is protected by copyright. All rights reserved.