Diabetes & metabolic syndromeJul 2, 2024

Semaglutide's potential to prevent irregular heartbeats: A combined analysis of studies

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 1, 2026

Abstract

Semaglutide decreased atrial fibrillation occurrence by 30% compared to control drugs in a pooled analysis of 25,957 patients.

The overall risk of atrial fibrillation was reduced with semaglutide, showing a relative risk of 0.70.
A significant decrease in atrial fibrillation occurrence was observed when semaglutide was compared to other antihyperglycemic medications (RR 0.43).
No significant reduction in atrial fibrillation was found in placebo-controlled trials (RR 0.77).
Patients with type 2 diabetes mellitus experienced a favorable outcome, with a relative risk of 0.71.
In patients with overweight or obesity, the results were inconclusive, showing a relative risk of 0.56, which was not statistically significant.
Oral semaglutide demonstrated a more pronounced effect on reducing atrial fibrillation risk (RR 0.49) compared to subcutaneous semaglutide (RR 0.77).

Simplified

BACKGROUND: Semaglutide, a glucagon-like peptide-1 receptor agonist, is reported to have cardiac benefits, but its effects on preventing atrial fibrillation (AF) remain inconclusive. This study aimed to investigate whether semaglutide can prevent AF occurrence in patients with type 2 diabetes mellitus (T2DM), obesity, or overweight.

METHODS: We searched MEDLINE, EMBASE, the Cochrane CENTRAL database, and clinicaltrials.gov from inception to December 29, 2023. Randomized controlled trials of semaglutide in patients with T2DM, obesity, or overweight were included. The primary outcome was AF occurrence. Relative risks (RRs) with 95 % confidence intervals (CIs) were calculated for the overall population and subgroups.

RESULTS: Twenty-one trials comprising 25957 patients were included. In the overall pooled analysis, semaglutide decreased AF occurrence compared to control drugs (RR 0.70, 95 % CI 0.52-0.95). This result was consistent in trials using other antihyperglycemic medications as controls (RR 0.43, 95 % CI 0.21-0.89), but not in placebo-controlled trials (RR 0.77, 95 % CI 0.56-1.07). The outcome was favorable for patients with T2DM (RR 0.71, 95 % CI 0.52-0.97), but not for patients with overweight or obesity (RR 0.56, 95 % CI 0.18-1.73). Results varied by type of semaglutide, with oral semaglutide showing an RR of 0.49 (95 % CI 0.25-0.97) and subcutaneous semaglutide showing an RR of 0.77 (95 % CI 0.55-1.07).

CONCLUSION: Semaglutide was associated with a reduced risk of AF occurrence in the overall analysis. Favorable outcomes were observed in subsets using other antihyperglycemic medications as controls, in patients with T2DM, and with oral semaglutide.

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Declaration of competing interest 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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Semaglutide's potential to prevent irregular heartbeats: A combined analysis of studies

Abstract

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Abstract

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