Meta-analysis of cardiovascular outcome trials assessing the impact of glucagon-like peptide-1 receptor agonists on major cardiac arrhythmias

• Published in: Acta Cardiologica 2023-07, Vol.78 (5), p.519-524
• Main Authors: Boulmpou, Aristi, Patoulias, Dimitrios, Papadopoulos, Christodoulos E., Teperikidis, Eleftherios, Doumas, Michael, Vassilikos, Vassilios
• Format: Article
• Language: English
• Subjects: arrhythmia; Arrhythmias, Cardiac - drug therapy; atrial fibrillation; Atrioventricular Block; cardiovascular disease; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Glucagon-Like Peptide-1 Receptor - agonists; Glucagon-Like Peptide-1 Receptor - therapeutic use; Glucagon-like peptide-1 receptor agonist; Humans; Hypoglycemic Agents - therapeutic use; type 2 diabetes
• ISSN: 0001-5385; 0373-7934; 1784-973X
• DOI: 10.1080/00015385.2022.2087839

Glucagon-like peptide-1 receptor agonists (GLP-1RAs), a group of novel antidiabetic agents, demonstrated beneficial cardiovascular effects in recent large, placebo-controlled randomised clinical trials (RCTs); their clear antiarrhythmic benefit has not been yet underlined. The purpose of the present meta-analysis is to clarify the impact of GLP-1RAs on different types of cardiac arrhythmias. We searched PubMed from its inception up to 8 October 2020 for all available cardiovascular and renal outcome, placebo-controlled RCTs utilising GLP-1RAs versus placebo. The present meta-analysis is reported according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) statement. We included data from 7 RCTs with GLP-1RAs in a total of 55,943 participants. Treatment with GLP-1RAs did not provide significant benefit in the risk for atrial fibrillation (RR = 0.81, 95%CI; 0.78-1.15, I 2 = 51%), atrial flutter (RR = 0.79, 95%CI; 0.53-1.16, I 2 = 0%), ventricular fibrillation (RR = 0.99, 95%CI; 0.48-2.04, I 2 = 0%), ventricular tachycardia (RR = 1.41, 95%CI; 0.87-2.28, I 2 = 10%), atrial tachycardia (RR = 0.63, 95%CI; 0.10-3.90, I 2 = 24%), sinus node dysfunction (RR = 0.70, 95%CI; 0.40-1.23, I 2 = 0%), ventricular extrasystoles (RR = 1.37, 95%CI; 0.56-3.30, I 2 = 0%), second-degree atrioventricular block (RR = 0.96, 95%CI; 0.52-1.74, I 2 = 0%) or complete atrioventricular block (RR = 0.78, 95%CI; 0.39-1.54, I 2 = 38%). In patients with type 2 diabetes mellitus, treatment with GLP-1RAs does not significantly affect the risk for major cardiac arrhythmias.