Efficacy and safety of liraglutide in type 2 diabetes mellitus patients complicated with coronary artery disease: A systematic review and meta-analysis of randomized controlled trials

Abstract

To evaluate the efficacy and safety of liraglutide in patients with Type 2 Diabetes Mellitus (T2DM) complicated with Coronary Artery Disease (CAD), we searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Chinese VIP Information (VIP), Wanfang Database and Chinese Biomedical Literature database (CBM) for relevant randomized controlled trials (RCTs) from inception to 7 October 2020. A total of 18 RCTs including 1557 patients with T2DM complicated with CAD were included. Meta-analysis revealed liraglutide reduced hemoglobin A1c (HbA1c) (WMD = −0.67; 95% CI[−0.94 to −0.39]; P < 0.00001), fasting plasma glucose (FPG) (WMD = −0.80; 95% CI[−1.06 to −0.54]; P < 0.00001) and 2 h plasma glucose (2hPG) (WMD = −1.64; 95% CI[−2.12 to −1.16]; P＜0.00001); improved left ventricular ejection fraction(LVEF) (WMD = 4.79; 95% CI[4.08–5.51]; P < 0.00001), left ventricular end-diastolic diameter (LVEDD) (WMD = −5.70; 95% CI[−6.67 to −4.72]; P＜0.00001), E/A (WMD = 0.13; 95% CI[0.11–0.14]; P < 0.00001) and left ventricular posterior wall thickness (LVPWT) (WMD = −1.86; 95% CI[−2.16 to −1.55]; P < 0.00001); reduced total cholesterol (TC) (WMD = −0.48; 95% CI[−0.56 to −0.39]; P < 0.00001), triglycerides (TG) (WMD = −0.42; 95% CI[−0.59 to −0.26]; P < 0.00001), low-density lipoprotein cholesterol (LDL-C) (WMD = −0.41; 95% CI[−0.55 to −0.26]; P < 0.00001), and increased high-density lipoprotein cholesterol (HDL-C) (WMD = −0.19; 95% CI[0.13–0.24]; P = 0.0005). As for safety assessment, liraglutide did not increase the incidence of hypoglycemia (OR = 0.75, 95% CI[0.32–1.77], P = 0.51) and gastrointestinal (OR = 1.15, 95% CI[0.72–1.85], P = 0.55) events. Consequently, liraglutide had favorable effects on blood glucose, cardiac function, lipid profile and an acceptable safety profile.