Comparative outcomes of heart failure among existent classes of anti-diabetic agents: a network meta-analysis of 171,253 participants from 91 randomized controlled trials
Abstract Background The cardiovascular (CV) safety in terms of heart failure among different classes of treatment remains largely unknown. We sought to assess the comparative effect of these agents on heart failure outcomes. Methods This study was registered in the International Prospective Register...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12933-019-0853-x |
| _version_ | 1828164699720515584 |
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| author | Da-ya Yang Xin He Hui-wei Liang Shao-zhao Zhang Xiang-bin Zhong Chu-fan Luo Zhi-min Du Jian-gui He Xiao-dong Zhuang Xin-xue Liao |
| author_facet | Da-ya Yang Xin He Hui-wei Liang Shao-zhao Zhang Xiang-bin Zhong Chu-fan Luo Zhi-min Du Jian-gui He Xiao-dong Zhuang Xin-xue Liao |
| author_sort | Da-ya Yang |
| collection | DOAJ |
| description | Abstract Background The cardiovascular (CV) safety in terms of heart failure among different classes of treatment remains largely unknown. We sought to assess the comparative effect of these agents on heart failure outcomes. Methods This study was registered in the International Prospective Register of Systematic Reviews (CRD 42016042063). MEDLINE, EMBASE, and the Cochrane Library Central Register of Controlled Trials were searched. For the primary outcomes reported previously, studies between Jan 1, 1980 and June 30, 2016 were screened, and subsequently updated till Jan 24, 2019. We performed network meta-analysis to obtain estimates for the outcomes of heart failure, in particular by rankograms for ranking of heart failure risk as well as by pairwise comparisons among all classes of anti-diabetic medications. Results A total of 91 trials were included, among which were 171,253 participants and 4163 reported cases of heart failure events. As for rankograms, the surface under the cumulative ranking curves (SUCRA) of sodium-glucose co-transporters 2 and thiazolidinediones were 93.4% and 4.3%, respectively, signifying the lowest and highest risk of heart failure, respectively. As for pairwise comparisons in the network, sodium-glucose co-transporters 2 were significantly superior to insulin (OR: 0.75, 95% CI 0.62–0.91), dipeptidyl peptidase 4 inhibitors (OR: 0.68, 95% CI 0.59–0.78), glucagon-like peptide-1 receptor agonists (OR: 0.65, 95% CI 0.54–0.78), and thiazolidinediones (OR: 0.46, 95% CI 0.27–0.77) in terms of heart failure risk. Furthermore, in an exploratory analysis among subjects with underlying heart failure or at risk of heart failure, the superiority of sodium-glucose co-transporters 2 was still significant. Conclusions In terms of heart failure risk, sodium-glucose co-transporters 2 were the most favorable option among all classes of anti-diabetic medications. |
| first_indexed | 2024-04-12T01:30:57Z |
| format | Article |
| id | doaj.art-86c68e82a0be413d8aeff7eb7c9b573a |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-12T01:30:57Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-86c68e82a0be413d8aeff7eb7c9b573a2022-12-22T03:53:29ZengBMCCardiovascular Diabetology1475-28402019-04-011811810.1186/s12933-019-0853-xComparative outcomes of heart failure among existent classes of anti-diabetic agents: a network meta-analysis of 171,253 participants from 91 randomized controlled trialsDa-ya Yang0Xin He1Hui-wei Liang2Shao-zhao Zhang3Xiang-bin Zhong4Chu-fan Luo5Zhi-min Du6Jian-gui He7Xiao-dong Zhuang8Xin-xue Liao9Department of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityAdministrative Office of Clinical Trial Center, Guangzhou Hui-Ai HospitalDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, First Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background The cardiovascular (CV) safety in terms of heart failure among different classes of treatment remains largely unknown. We sought to assess the comparative effect of these agents on heart failure outcomes. Methods This study was registered in the International Prospective Register of Systematic Reviews (CRD 42016042063). MEDLINE, EMBASE, and the Cochrane Library Central Register of Controlled Trials were searched. For the primary outcomes reported previously, studies between Jan 1, 1980 and June 30, 2016 were screened, and subsequently updated till Jan 24, 2019. We performed network meta-analysis to obtain estimates for the outcomes of heart failure, in particular by rankograms for ranking of heart failure risk as well as by pairwise comparisons among all classes of anti-diabetic medications. Results A total of 91 trials were included, among which were 171,253 participants and 4163 reported cases of heart failure events. As for rankograms, the surface under the cumulative ranking curves (SUCRA) of sodium-glucose co-transporters 2 and thiazolidinediones were 93.4% and 4.3%, respectively, signifying the lowest and highest risk of heart failure, respectively. As for pairwise comparisons in the network, sodium-glucose co-transporters 2 were significantly superior to insulin (OR: 0.75, 95% CI 0.62–0.91), dipeptidyl peptidase 4 inhibitors (OR: 0.68, 95% CI 0.59–0.78), glucagon-like peptide-1 receptor agonists (OR: 0.65, 95% CI 0.54–0.78), and thiazolidinediones (OR: 0.46, 95% CI 0.27–0.77) in terms of heart failure risk. Furthermore, in an exploratory analysis among subjects with underlying heart failure or at risk of heart failure, the superiority of sodium-glucose co-transporters 2 was still significant. Conclusions In terms of heart failure risk, sodium-glucose co-transporters 2 were the most favorable option among all classes of anti-diabetic medications.http://link.springer.com/article/10.1186/s12933-019-0853-xCardiovascularMeta-analysisHeart failureDiabetesAgent |
| spellingShingle | Da-ya Yang Xin He Hui-wei Liang Shao-zhao Zhang Xiang-bin Zhong Chu-fan Luo Zhi-min Du Jian-gui He Xiao-dong Zhuang Xin-xue Liao Comparative outcomes of heart failure among existent classes of anti-diabetic agents: a network meta-analysis of 171,253 participants from 91 randomized controlled trials Cardiovascular Diabetology Cardiovascular Meta-analysis Heart failure Diabetes Agent |
| title | Comparative outcomes of heart failure among existent classes of anti-diabetic agents: a network meta-analysis of 171,253 participants from 91 randomized controlled trials |
| title_full | Comparative outcomes of heart failure among existent classes of anti-diabetic agents: a network meta-analysis of 171,253 participants from 91 randomized controlled trials |
| title_fullStr | Comparative outcomes of heart failure among existent classes of anti-diabetic agents: a network meta-analysis of 171,253 participants from 91 randomized controlled trials |
| title_full_unstemmed | Comparative outcomes of heart failure among existent classes of anti-diabetic agents: a network meta-analysis of 171,253 participants from 91 randomized controlled trials |
| title_short | Comparative outcomes of heart failure among existent classes of anti-diabetic agents: a network meta-analysis of 171,253 participants from 91 randomized controlled trials |
| title_sort | comparative outcomes of heart failure among existent classes of anti diabetic agents a network meta analysis of 171 253 participants from 91 randomized controlled trials |
| topic | Cardiovascular Meta-analysis Heart failure Diabetes Agent |
| url | http://link.springer.com/article/10.1186/s12933-019-0853-x |
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