Diabetes, obesity & metabolismOct 10, 2019

Glucagon-like peptide-1 receptor drugs and heart health in patients with or without previous heart problems: Updated analysis of clinical trials

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 28, 2026

Abstract

GLP-1 receptor agonist treatment was associated with a 17% reduction in major adverse cardiovascular events (MACE).

In seven placebo-controlled trials, GLP-1 receptor agonists showed a reduction in MACE with a Mantel-Haenszel odds ratio of 0.87.
Cardiovascular mortality decreased with a Mantel-Haenszel odds ratio of 0.88.
Myocardial infarction and stroke rates were also reduced, with odds ratios of 0.90 and 0.86, respectively.
Hospitalization for heart failure did not show a statistically significant reduction, with an odds ratio of 0.93.
The reduction in MACE was significant across various patient subgroups, including different genders, ages, and obesity levels.

Simplified

AIM: To conduct a meta-analysis of cardiovascular outcome trials on the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on major adverse cardiovascular events (MACE).

METHODS: A search of MEDLINE, EMBASE, Cochrane database and clinicaltrials.gov was performed to identify controlled trials (up to 15 June 2019) of GLP-1RAs with a cardiovascular endpoint. The principal endpoint of the present meta-analysis was MACE; secondary endpoints included myocardial infarction, stroke, cardiovascular and all-cause mortality, and hospitalization for heart failure. Mantel-Haenszel odds ratios (MH-ORs) with 95% confidence intervals (CIs) were calculated for all outcomes.

RESULTS: In the seven trials included, all placebo-controlled, GLP-1RA treatment was associated with a reduction in MACE (MH-OR 0.87 [95% CI 0.81, 0.93]). Cardiovascular and all-cause mortality, myocardial infarction and stroke were also reduced (MH-OR 0.88 [95% CI 0.80, 0.96], MH-OR 0.90 [95% CI 0.82, 0.98], MH-OR 0.91 [95% CI 0.84, 0.98] and MH-OR 0.86 [95% CI 0.77, 0.97], respectively). Results for hospitalization for heart failure were not statistically significant (MH-OR 0.93 [95% CI 0.83, 1.04]). The meta-analyses of patient subgroups showed a significant reduction in MACE with GLP-1RAs, irrespective of gender, advanced age and obesity.

CONCLUSIONS: GLP-1RAs are associated with a reduction in cardiovascular morbidity and mortality in high-risk patients with diabetes. This effect does not appear to be moderated by gender or body mass index. The possibility of different effects of GLP-1RAs between patients in primary and secondary prevention merits further investigation.

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Glucagon-like peptide-1 receptor drugs and heart health in patients with or without previous heart problems: Updated analysis of clinical trials

Abstract

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