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Cardiovascular and renal outcomes of GLP-1 receptor agonists in type 2 diabetes mellitus: a systematic review and

Mushood Ahmed1, Tallal Mushtaq Hashmi1, Maryam Shahzad2

  • 1Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan.

European Heart Journal. Quality of Care & Clinical Outcomes
|May 16, 2026
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) significantly reduce cardiovascular events and all-cause mortality in type 2 diabetes mellitus (T2DM) patients. These findings confirm the cardioprotective benefits of GLP-1RAs beyond glucose control.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established treatments for type 2 diabetes mellitus (T2DM).
  • GLP-1RAs offer both glycemic control and cardiovascular benefits.
  • This study systematically reviews GLP-1RA impact on cardiovascular outcomes in T2DM.

Purpose of the Study:

  • To evaluate the cardiovascular impact of GLP-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes mellitus (T2DM).
  • To synthesize evidence from randomized controlled trials (RCTs) on GLP-1RA cardiovascular outcomes.

Main Methods:

  • A systematic literature search was performed in PubMed, Embase, and Cochrane Library up to March 31, 2025.
  • Twenty randomized controlled trials (RCTs) involving 83,004 patients were included.
  • Risk ratios (RR) and 95% confidence intervals (CIs) were calculated using a random-effects model.

Main Results:

  • GLP-1RAs significantly reduced major adverse cardiovascular events (RR 0.87), all-cause death (RR 0.89), cardiovascular death (RR 0.88), myocardial infarction (RR 0.87), stroke (RR 0.88), and composite renal outcomes (RR 0.80).
  • A trend towards reduced heart failure hospitalizations (RR 0.93) and coronary revascularization (RR 0.87) was observed.
  • These benefits were statistically significant compared to placebo in T2DM patients.

Conclusions:

  • GLP-1 receptor agonists (GLP-1RAs) demonstrate significant cardiovascular protective effects in patients with type 2 diabetes mellitus (T2DM).
  • These findings support the use of GLP-1RAs for cardiovascular risk reduction in T2DM.
  • The cardioprotective benefits extend beyond glycemic control, aligning with current clinical guidelines.
Keywords:
Cardiovascular outcomesGLP-1 receptor agonistsMeta-analysisType 2 diabetes

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