Cardiovascular effect of incretin-based therapy in patients with type 2 diabetes mellitus: Systematic review and meta-Analysis
Je Yon Kim, Seungwon Yang, Jangik I. Lee, Min Jung Chang
Background: To assess the cardiovascular (CV) risk associated with the use of incretin-based therapy in adult patients with type 2 diabetes mellitus (T2DM) primary prevention group with low CV risks. Methods: The clinical studies on incretin-based therapy published in medical journals until August 2014 were comprehensively searched using MEDLINE, EMBASE and CENTRAL with no language restriction. The studies were systemically reviewed and evaluated for CV risks using a metaanalysis approach and where they meet the following criteria: clinical trial, incidence of predefined CV disease, T2DM with no comorbidities, age > 18 years old, duration of at least 12 weeks, incretin-based therapy compared with other antihyperglycaemic agents or placebo. Statistical analyses were performed using a Mantel-Haenszel (M-H) test. The odds ratios (OR) and their 95% confidence interval (CI) were estimated and displayed for comparison. Results: A total of 75 studies comprising 45,648 patients with T2DM were selected. The pooled estimate demonstrated no significance in decreased CV risk with incretin-based therapy versus control (M-H OR, 0.90; 95% CI, 0.81-1.00). Conclusions: This meta-analysis suggests that incretin-based therapy show no significant protective effect on CV events in T2DM primary prevention group with low CV risks. Prospective randomized controlled trials are required to confirm the results of this analysis.
Authors would like to thank Mr. Byunghak Jin, Mr. Jaeyul Yoo for their contributions to this research. This study was supported by Global Center of Excellence in Clinical Trials (HI14C1234), Yonsei University Health System funded by Ministry of Health & Welfare, Republic of Korea.
© 2016 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Agricultural and Biological Sciences(all)
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secretin Agriculture & Biology 100%
systematic review Agriculture & Biology 98%
Incretins Medicine & Life Sciences 98%
noninsulin-dependent diabetes mellitus Agriculture & Biology 96%
Antidiabetic Agent Chemistry 92%
meta-analysis Agriculture & Biology 86%
Protective Chemistry 62%
therapeutics Agriculture & Biology 58%
Kim, J. Y., Yang, S., Lee, J. I., & Chang, M. J. (2016). Cardiovascular effect of incretin-based therapy in patients with type 2 diabetes mellitus: Systematic review and meta-Analysis. PloS one, 11(4), [e0153502]. https://doi.org/10.1371/journal.pone.0153502
Kim, Je Yon ; Yang, Seungwon ; Lee, Jangik I. ; Chang, Min Jung. / Cardiovascular effect of incretin-based therapy in patients with type 2 diabetes mellitus : Systematic review and meta-Analysis. In: PloS one. 2016 ; Vol. 11, No. 4.
@article{d3b3993a0b6142b9b2253f0ca688a729,
title = "Cardiovascular effect of incretin-based therapy in patients with type 2 diabetes mellitus: Systematic review and meta-Analysis",
abstract = "Background: To assess the cardiovascular (CV) risk associated with the use of incretin-based therapy in adult patients with type 2 diabetes mellitus (T2DM) primary prevention group with low CV risks. Methods: The clinical studies on incretin-based therapy published in medical journals until August 2014 were comprehensively searched using MEDLINE, EMBASE and CENTRAL with no language restriction. The studies were systemically reviewed and evaluated for CV risks using a metaanalysis approach and where they meet the following criteria: clinical trial, incidence of predefined CV disease, T2DM with no comorbidities, age > 18 years old, duration of at least 12 weeks, incretin-based therapy compared with other antihyperglycaemic agents or placebo. Statistical analyses were performed using a Mantel-Haenszel (M-H) test. The odds ratios (OR) and their 95% confidence interval (CI) were estimated and displayed for comparison. Results: A total of 75 studies comprising 45,648 patients with T2DM were selected. The pooled estimate demonstrated no significance in decreased CV risk with incretin-based therapy versus control (M-H OR, 0.90; 95% CI, 0.81-1.00). Conclusions: This meta-analysis suggests that incretin-based therapy show no significant protective effect on CV events in T2DM primary prevention group with low CV risks. Prospective randomized controlled trials are required to confirm the results of this analysis.",
author = "Kim, {Je Yon} and Seungwon Yang and Lee, {Jangik I.} and Chang, {Min Jung}",
note = "Funding Information: Authors would like to thank Mr. Byunghak Jin, Mr. Jaeyul Yoo for their contributions to this research. This study was supported by Global Center of Excellence in Clinical Trials (HI14C1234), Yonsei University Health System funded by Ministry of Health & Welfare, Republic of Korea. Publisher Copyright: {\textcopyright} 2016 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",
Kim, JY, Yang, S, Lee, JI & Chang, MJ 2016, 'Cardiovascular effect of incretin-based therapy in patients with type 2 diabetes mellitus: Systematic review and meta-Analysis', PloS one, vol. 11, no. 4, e0153502. https://doi.org/10.1371/journal.pone.0153502
Cardiovascular effect of incretin-based therapy in patients with type 2 diabetes mellitus : Systematic review and meta-Analysis. / Kim, Je Yon; Yang, Seungwon; Lee, Jangik I.; Chang, Min Jung.
In: PloS one, Vol. 11, No. 4, e0153502, 04.2016.
T1 - Cardiovascular effect of incretin-based therapy in patients with type 2 diabetes mellitus
T2 - Systematic review and meta-Analysis
AU - Kim, Je Yon
AU - Yang, Seungwon
AU - Lee, Jangik I.
AU - Chang, Min Jung
N1 - Funding Information: Authors would like to thank Mr. Byunghak Jin, Mr. Jaeyul Yoo for their contributions to this research. This study was supported by Global Center of Excellence in Clinical Trials (HI14C1234), Yonsei University Health System funded by Ministry of Health & Welfare, Republic of Korea. Publisher Copyright: © 2016 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
N2 - Background: To assess the cardiovascular (CV) risk associated with the use of incretin-based therapy in adult patients with type 2 diabetes mellitus (T2DM) primary prevention group with low CV risks. Methods: The clinical studies on incretin-based therapy published in medical journals until August 2014 were comprehensively searched using MEDLINE, EMBASE and CENTRAL with no language restriction. The studies were systemically reviewed and evaluated for CV risks using a metaanalysis approach and where they meet the following criteria: clinical trial, incidence of predefined CV disease, T2DM with no comorbidities, age > 18 years old, duration of at least 12 weeks, incretin-based therapy compared with other antihyperglycaemic agents or placebo. Statistical analyses were performed using a Mantel-Haenszel (M-H) test. The odds ratios (OR) and their 95% confidence interval (CI) were estimated and displayed for comparison. Results: A total of 75 studies comprising 45,648 patients with T2DM were selected. The pooled estimate demonstrated no significance in decreased CV risk with incretin-based therapy versus control (M-H OR, 0.90; 95% CI, 0.81-1.00). Conclusions: This meta-analysis suggests that incretin-based therapy show no significant protective effect on CV events in T2DM primary prevention group with low CV risks. Prospective randomized controlled trials are required to confirm the results of this analysis.
AB - Background: To assess the cardiovascular (CV) risk associated with the use of incretin-based therapy in adult patients with type 2 diabetes mellitus (T2DM) primary prevention group with low CV risks. Methods: The clinical studies on incretin-based therapy published in medical journals until August 2014 were comprehensively searched using MEDLINE, EMBASE and CENTRAL with no language restriction. The studies were systemically reviewed and evaluated for CV risks using a metaanalysis approach and where they meet the following criteria: clinical trial, incidence of predefined CV disease, T2DM with no comorbidities, age > 18 years old, duration of at least 12 weeks, incretin-based therapy compared with other antihyperglycaemic agents or placebo. Statistical analyses were performed using a Mantel-Haenszel (M-H) test. The odds ratios (OR) and their 95% confidence interval (CI) were estimated and displayed for comparison. Results: A total of 75 studies comprising 45,648 patients with T2DM were selected. The pooled estimate demonstrated no significance in decreased CV risk with incretin-based therapy versus control (M-H OR, 0.90; 95% CI, 0.81-1.00). Conclusions: This meta-analysis suggests that incretin-based therapy show no significant protective effect on CV events in T2DM primary prevention group with low CV risks. Prospective randomized controlled trials are required to confirm the results of this analysis.
Kim JY, Yang S, Lee JI, Chang MJ. Cardiovascular effect of incretin-based therapy in patients with type 2 diabetes mellitus: Systematic review and meta-Analysis. PloS one. 2016 Apr;11(4). e0153502. https://doi.org/10.1371/journal.pone.0153502