PMID- 31870322
OWN - NLM
STAT- MEDLINE
DCOM- 20200622
LR  - 20231027
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 19
IP  - 1
DP  - 2019 Dec 23
TI  - Targeting the DPP-4-GLP-1 pathway improves exercise tolerance in heart failure 
      patients: a systematic review and meta-analysis.
PG  - 311
LID - 10.1186/s12872-019-01275-5 [doi]
LID - 311
AB  - BACKGROUND: The most significant manifestation of heart failure is exercise 
      intolerance. This systematic review and meta-analysis was performed to 
      investigate whether dipeptidyl peptidase-4 (DPP-4) inhibitors or glucagon-like 
      peptide 1 receptor agonists (GLP-1 RAs), widely used anti-diabetic drugs, could 
      improve exercise tolerance in heart failure patients with or without type 2 
      diabetes mellitus. METHODS: An electronic search of PubMed, EMBASE and the 
      Cochrane Library was carried out through March 8th, 2019, for eligible trials. 
      Only randomized controlled studies were included. The primary outcome was 
      exercise tolerance [6-min walk test (6MWT) and peak O(2) consumption], and the 
      secondary outcomes included quality of life (QoL), adverse events (AEs) and 
      all-cause death. RESULT: After the literature was screened by two reviewers 
      independently, four trials (659 patients) conducted with heart failure patients 
      with or without type 2 diabetes met the eligibility criteria. The results 
      suggested that targeting the DPP-4-GLP-1 pathway can improve exercise tolerance 
      in heart failure patients [MD 24.88 (95% CI 5.45, 44.31), P = 0.01] without 
      decreasing QoL [SMD -0.51 (95% CI -1.13, 0.10), P = 0.10]; additionally, 
      targeting the DPP-4-GLP-1 pathway did not show signs of increasing the incidence 
      of serious AEs or mortality. CONCLUSION: Our results suggest that DPP-4 
      inhibitors or GLP-1 RAs improve exercise tolerance in heart failure patients. 
      Although the use of these drugs for heart failure has not been approved by any 
      organization, they may be a better choice for type 2 diabetes mellitus patients 
      with heart failure. Furthermore, as this pathway contributes to the improvement 
      of exercise tolerance, it may be worth further investigation in 
      exercise-intolerant patients with other diseases.
FAU - Chen, Chengcong
AU  - Chen C
AD  - Section of Endocrinology, Department of Pediatrics, Shenzhen Maternity & Child 
      Healthcare Hospital, Shenzhen, China.
FAU - Huang, Ying
AU  - Huang Y
AD  - School of Public Health, Chinese University of Hong Kong, Hong Kong, China.
FAU - Zeng, Yongmei
AU  - Zeng Y
AD  - Section of Gastroenterology, Department of Pediatrics, Shenzhen Maternity&Child 
      Healthcare Hospital, Shenzhen, China.
FAU - Lu, Xiyan
AU  - Lu X
AD  - Section of Endocrinology, Department of Pediatrics, Shenzhen Maternity & Child 
      Healthcare Hospital, Shenzhen, China.
FAU - Dong, Guoqing
AU  - Dong G
AUID- ORCID: 0000-0002-3791-1700
AD  - Section of Endocrinology, Department of Pediatrics, Shenzhen Maternity & Child 
      Healthcare Hospital, Shenzhen, China. szdonggq@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20191223
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (GLP1R protein, human)
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - 0 (Incretins)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
RN  - EC 3.4.14.5 (DPP4 protein, human)
RN  - EC 3.4.14.5 (Dipeptidyl Peptidase 4)
SB  - IM
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*drug therapy/metabolism/mortality/physiopathology
MH  - Dipeptidyl Peptidase 4/*metabolism
MH  - Dipeptidyl-Peptidase IV Inhibitors/adverse effects/*therapeutic use
MH  - Exercise Tolerance/*drug effects
MH  - Female
MH  - Glucagon-Like Peptide 1/*metabolism
MH  - Glucagon-Like Peptide-1 Receptor/*agonists/metabolism
MH  - Heart Failure/*drug therapy/metabolism/mortality/physiopathology
MH  - Humans
MH  - Incretins/adverse effects/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
MH  - Recovery of Function
MH  - Signal Transduction
MH  - Treatment Outcome
PMC - PMC6927173
OTO - NOTNLM
OT  - DPP-4 inhibitor
OT  - Exercise tolerance
OT  - GLP-1 receptor agonist
OT  - Heart failure
COIS- The authors declare that they have no competing interests.
EDAT- 2019/12/25 06:00
MHDA- 2020/06/23 06:00
PMCR- 2019/12/23
CRDT- 2019/12/25 06:00
PHST- 2019/03/25 00:00 [received]
PHST- 2019/11/22 00:00 [accepted]
PHST- 2019/12/25 06:00 [entrez]
PHST- 2019/12/25 06:00 [pubmed]
PHST- 2020/06/23 06:00 [medline]
PHST- 2019/12/23 00:00 [pmc-release]
AID - 10.1186/s12872-019-01275-5 [pii]
AID - 1275 [pii]
AID - 10.1186/s12872-019-01275-5 [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2019 Dec 23;19(1):311. doi: 10.1186/s12872-019-01275-5.