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Regional variation of effects of new antidiabetic medications in cardiovascular outcome trials.
Cotter, Gad; Davison, Beth A; Edwards, Christopher; Senger, Stefanie; Teerlink, John R; Zannad, Faiez; Nielsen, Olav Wendelboe; Metra, Marco; Mebazaa, Alexandre; Chioncel, Ovidiu; Greenberg, Barry H; Maggioni, Aldo P; Ertl, Georg; Sato, Naoki; Cohen-Solal, Alain.
Afiliación
  • Cotter G; Momentum Research Inc, Durham, North Carolina; Inserm U942 MASCOT, Paris, France. Electronic address: gadcotter@momentum-research.com.
  • Davison BA; Momentum Research Inc, Durham, North Carolina; Inserm U942 MASCOT, Paris, France.
  • Edwards C; Momentum Research Inc, Durham, North Carolina.
  • Senger S; Momentum Research Inc, Durham, North Carolina.
  • Teerlink JR; Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco,San Francisco, CA.
  • Zannad F; Inserm CIC-P 1433, Université de Lorraine, CHRU de Nancy, FCRIN INI-CRCT, Nancy, France.
  • Nielsen OW; Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Denmark.
  • Metra M; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy.
  • Mebazaa A; Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Université de Paris, Paris, France.
  • Chioncel O; University of Medicine Carol Davila, Bucharest, Romania.
  • Greenberg BH; Division of Cardiology, University of California San Diego, California.
  • Maggioni AP; Associazione Nazionale Medici Cardiologi Ospedalien (ANMCO) Research Center, Florence, Italy.
  • Ertl G; Julius-Maximilians-Universität Würzburg, Germany.
  • Sato N; Cardiology and Intensive Care Unit, Nippon Medical School, Musashi-Kosugi Hospital, Kawasaki, Japan.
  • Cohen-Solal A; Service de Cardiologie, Hôpital Lariboisière, 75010 Paris, France.
Am Heart J ; 240: 73-80, 2021 10.
Article en En | MEDLINE | ID: mdl-34107289
BACKGROUND: In international trials, glucagon-like protein-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2Is) were effective in improving cardiovascular (CV) outcomes. METHODS: We assessed the effect of GLP-1RAs and SGLT2Is treatment effect on CV endpoints by geographical region in multiple international trials using random effects weighted least squares meta-regressions. RESULTS: The estimated effects of both SGLT2Is and GLP-1RAs on major adverse CV events (MACE) in North America (SGLT2Is n = 12,399, HR 0.90, 95% CI 0.81-1.01; GLP-1RAs n = 12,515, HR 0.95, 95% CI 0.83- 1.09) and in Europe (SGLT2Is n = 19,435, HR 0.93, 95% CI 0.85-1.02; GLP-1RAs n = 22,812, HR 0.88, 95% CI 0.79-0.99) were numerically lower but not statistically different to the rest of the world (ROW) (SGLT2Is n = 15,127, HR 0.83, 95% CI 0.75-0.92, p-value for interaction 0.26; GLP-1RAs n = 17,494, HR 0.82, 95% CI 0.73-0.92, p-value for interaction 0.28). Effects of SGLT2Is on heart failure readmission or CV death varied significantly by region (P = 0.0094). The effect of SGLT2Is was significantly smaller in Europe (n = 18,653, HR 0.86, 95% CI 0.78-0.95) than in the ROW (n = 12,463, HR 0.68, 95% CI 0.61-0.76, P = 0.0024). The smaller effect in North America (n = 9776, HR 0.76, 95% CI 0.66-0.87) did not differ significantly from that in the ROW (P = 0.2370). CONCLUSION: The effects of SGLT2Is on HF events are larger in the ROW. Further analyses and studies are needed to better elucidate the differential effects of SGLTIs and GLP-1RAs by geographical regions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Diabetes Mellitus Tipo 2 / Receptor del Péptido 1 Similar al Glucagón / Inhibidores del Cotransportador de Sodio-Glucosa 2 / Hipoglucemiantes Tipo de estudio: Diagnostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Am Heart J Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Diabetes Mellitus Tipo 2 / Receptor del Péptido 1 Similar al Glucagón / Inhibidores del Cotransportador de Sodio-Glucosa 2 / Hipoglucemiantes Tipo de estudio: Diagnostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Am Heart J Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos