American journal of preventive cardiologyMay 23, 2024

Heart and kidney effects of glucagon-like peptide 1 receptor drugs in people with and without type 2 diabetes

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 26, 2026

Abstract

GLP-1 receptor agonists (GLP-1RAs) significantly reduced major adverse cardiovascular events (MACEs) by 14% (OR 0.86) in a review of 13 trials involving 83,258 patients.

GLP-1RAs are associated with a 13% reduction in all-cause mortality (OR 0.87).
There is a 13% decrease in cardiovascular mortality (OR 0.87) with GLP-1RA treatment.
Fatal stroke risk is reduced by 26% (OR 0.74), while non-fatal stroke risk is lowered by 13% (OR 0.87).
Coronary revascularization procedures are reduced by 14% (OR 0.86) among patients treated with GLP-1RAs.
A composite kidney outcome shows a significant reduction of 24% (OR 0.76) with GLP-1RA therapy.
These benefits are consistent across different sexes, history of cardiovascular disease, body mass index, and kidney function levels.

Simplified

BACKGROUND: Multiple cardiovascular outcomes trials (CVOTs) have shown the efficacy of GLP-1RAs in reducing major adverse cardiovascular events (MACEs) for high-risk patients. However, some CVOTs failed to demonstrate cardiovascular benefits.

OBJECTIVES: We analyzed the impact of GLP-1RA on cardiovascular and renal outcomes in patients with or without T2DM, with subgroup analysis based on sex, estimated glomerular filtration rate (eGFR), body mass index (BMI), and history of cardiovascular disease (CVD).

METHODS: A comprehensive database search for placebo-controlled RCTs on GLP-1RA treatment was conducted until April 2024. Data extraction and quality assessment were carried out, employing a robust statistical analysis using a random effects model to determine outcomes with log odds ratios and 95 % confidence intervals (CIs).

RESULTS: A total of 13 CVOTs comprising 83,258 patients were included. GLP-1RAs significantly reduced MACE (OR 0.86, 95 % CI: 0.80 to 0.94,< 0.01) all-cause mortality OR 0.87, 95 % CI: 0.82 to 0.93,< 0.001, CV mortality (OR 0.87, 95 % CI: 0.81 to 0.94,< 0.001), stroke (fatal: OR 0.74, 95 % CI: 0.56 to 0.96,= 0.03; non-fatal: OR 0.87, 95 % CI: 0.79 to 0.96,= 0.005), coronary revascularization (OR 0.86, 95 % CI: 0.74 to 0.99,= 0.023), and composite kidney outcome (OR 0.76, 95 % CI: 0.67 to 0.85,< 0.001. GLP-1RA significantly reduced MACE in both sexes. Furthermore, GLP-1RA reduced MACE regardless of CVD history, BMI, and eGFR level. p p p p p p p

CONCLUSION: Significant reductions in MACE, overall and CV mortality, stroke, coronary revascularization, and composite kidney outcome with GLP-1RA treatment were noted across all subgroups.

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Competing interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Heart and kidney effects of glucagon-like peptide 1 receptor drugs in people with and without type 2 diabetes

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