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Effects of oral antidiabetic drugs and glucagon-like peptide-1 receptor agonists on left ventricular diastolic function in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis

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Abstract

The present study aimed to compare the effects of oral antidiabetic drugs (OADs) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) on left ventricular diastolic function in patients with type 2 diabetes mellitus using a network meta-analysis of randomized controlled trials (RCTs). Literature searches were conducted on Medline, the Cochrane Controlled Trials Registry, and ClinicalTrials.gov. RCTs that assessed the effects on left ventricular diastolic function of OADs and GLP-1RAs in patients with type 2 diabetes were included. The outcome was the value (E/e’) obtained by dividing peak early diastolic transmitral flow velocity (E) by the mitral annular early diastolic velocity (e’). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated from a random-effects network meta-analysis. Eight RCTs (592 patients) identified in a literature search met the eligibility criteria for this study and were included in the network meta-analysis. Compared with placebo, liraglutide was the only drug that caused a significant improvement in left ventricular diastolic function (SMD, − 0.65; 95% CI, − 1.23 to − 0.08). In addition, when the effects on left ventricular diastolic function were evaluated across drugs, liraglutide alone caused a significant improvement in left ventricular diastolic function compared with OADs (sitagliptin, linagliptin, pioglitazone, rosiglitazone, voglibose, and glimepiride). From the perspective of preventing the onset of heart failure, the administration of liraglutide for type 2 diabetes is promising.

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Abbreviations

CI:

Confidence interval

HFpEF:

Heart failure with preserved ejection fraction

LVDD:

Left ventricular diastolic dysfunction

MACE:

Major cardiovascular events

PRISMA:

Preferred reporting items for systematic reviews and meta-analysis

RCT:

Randomized controlled trials

SD:

Standard deviation

SE:

Standard error

SMD:

Standardized mean differences

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Acknowledgments

The authors would like to thank the staff members of the Department of Metabolic Diseases at the Ise Red Cross Hospital for their cooperation in this study.

Availability of data and materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Diabetes and Metabolism, Ise Red Cross Hospital, 1-471-2, Funae, 1-Chome, Ise-shi, Mie, 516-8512, Japan

    Satoshi Ida, Ryutaro Kaneko, Kanako Imataka, Kaoru Okubo, Yoshitaka Shirakura, Kentaro Azuma, Ryoko Fujiwara, Hiroka Takahashi & Kazuya Murata

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  1. Satoshi Ida
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  2. Ryutaro Kaneko
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Contributions

SI carried out the design of the study and drafted the manuscript; KM worked on giving advice and reviewing from a medical point of view; RK, KI, KO, YS, KA, RF, and HT helped to draft the manuscript. All authors read and approved the final manuscript.

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Correspondence to Satoshi Ida.

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The authors declare that they have no conflict of interest.

Ethics approval and consent to participate

This study was approved by the Ethical Review Board of the Ise Red Cross Hospital and conducted in accordance with the Helsinki Declaration. Written informed consents were obtained from all participants before enrolment.

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Ida, S., Kaneko, R., Imataka, K. et al. Effects of oral antidiabetic drugs and glucagon-like peptide-1 receptor agonists on left ventricular diastolic function in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. Heart Fail Rev 26, 1151–1158 (2021). https://doi.org/10.1007/s10741-020-09936-w

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