Annals of medicine · 2017
Protective effect of glucagon-like peptide-1 agents on reperfusion injury for acute myocardial infarction: a meta-analysis of randomized controlled trials.
СтатьяМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Huang Mengjie, Wei Ribao, Wang Yang, Su Tingyu, Li Qingping, Yang Xi, Chen Xiangmei
Аннотация
BACKGROUND: The cardioprotective properties of glucagon-like peptide-1 (GLP-1) receptor agonists in acute myocardial infarction (AMI) patients against reperfusion injury remain unclear. We performed a meta-analysis to assess their role in the acute phase of AMI.
METHODS AND RESULTS: Randomized controlled trials (RCTs) comparing GLP-1 agents with placebo in AMI patients undergoing percutaneous coronary intervention were identified by searching PubMed, Embase and Cochrane libraries. Six RCTs with 800 patients were included in the meta-analysis. Compared with placebo, GLP-1 agents improved left ventricular ejection fraction (LVEF) by 2.46 [95% confidence interval (CI): 0.23-4.70%] and reduced the infarct size in grams as well as in percentage of the area at risk [weighted mean difference (WMD) - 5.29, 95% CI: -10.39 to -0.19; WMD -0.08, 95% CI: -0.12 to -0.04, respectively]. The incidence of cardiovascular events appeared to be lower with GLP-1 therapy, but the statistical significance was not reached [relative risk (RR): 0.78; 95% CI: 0.58-1.06]. In terms of safety evaluation, GLP-1 treatment increased the risk of gastrointestinal adverse events (RR: 5.50, 95% CI: 2.85-10.60).
CONCLUSIONS: Our analysis shows that in patients with AMI undergoing PCI, GLP-1 treatment is associated with improved LVEF and reduced infarct size.
METHODS AND RESULTS: Randomized controlled trials (RCTs) comparing GLP-1 agents with placebo in AMI patients undergoing percutaneous coronary intervention were identified by searching PubMed, Embase and Cochrane libraries. Six RCTs with 800 patients were included in the meta-analysis. Compared with placebo, GLP-1 agents improved left ventricular ejection fraction (LVEF) by 2.46 [95% confidence interval (CI): 0.23-4.70%] and reduced the infarct size in grams as well as in percentage of the area at risk [weighted mean difference (WMD) - 5.29, 95% CI: -10.39 to -0.19; WMD -0.08, 95% CI: -0.12 to -0.04, respectively]. The incidence of cardiovascular events appeared to be lower with GLP-1 therapy, but the statistical significance was not reached [relative risk (RR): 0.78; 95% CI: 0.58-1.06]. In terms of safety evaluation, GLP-1 treatment increased the risk of gastrointestinal adverse events (RR: 5.50, 95% CI: 2.85-10.60).
CONCLUSIONS: Our analysis shows that in patients with AMI undergoing PCI, GLP-1 treatment is associated with improved LVEF and reduced infarct size.