Glucagon-like peptide-1 receptor agonists for primary cardiovascular disease prevention in type 2 diabetes, a systematic review
Authors' conclusion
Current evidence is insufficient to establish CV benefits of GLP-1 RAs in T2D without a history of CVD
Study context
- Population
- Patients with T2D without a history of CV disease (CVD) (primary CVD prevention), in randomized controlled trials (RCTs) with a cardiovascular (CV) or renal primary outcome; only 26% of participants were primary CVD prevention patients
- Participants
- 77,419 patients11 RCTs
- Comparison
- GLP-1 RA vs placebo
- Outcome
- MACE in primary CVD prevention
Methodological detailssubgroup analyses of aggregated data, Cochrane risk of bias tool version 1, Searched MEDLINE, Cochrane CENTRAL and Epistemonikos up to July 4, 2025
- Subgroup analyses of aggregated data
- Cochrane risk of bias tool version 1
- Searched MEDLINE, Cochrane CENTRAL and Epistemonikos up to July 4, 2025
Pooled result
As reported in the abstract
Pooled HR for major adverse cardiovascular events (MACE) (GLP-1 RA treatment effect in primary CVD prevention), not significant
0.88
95% CI 0.74 to 1.05
Further pooled results
All-cause mortality, CV mortality, MI, stroke (primary CVD prevention)
- Pooled estimates not significant for all secondary outcomes
Safety
Serious adverse events (primary CVD prevention)
- Pooled estimate not significant
Original publication
Glucagon-like peptide-1 receptor agonists for primary cardiovascular disease prevention in type 2 diabetes, a systematic review. BMJ Open Diabetes Res Care. Published 19 August 2026. doi:10.
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