---
title: "GLP-1 Receptor Agonists and Cardiovascular–Renal Outcomes in Type 2 Diabetes: Systematic Review &"
id: "pubmed-42142362"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42142362"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42142362/"
doi: "10.1093/ehjqcco/qcag079"
published_at: "2026-09-16T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# GLP-1 Receptor Agonists and Cardiovascular–Renal Outcomes in Type 2 Diabetes: Systematic Review &
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42142362
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42142362/)
- **DOI:** [10.1093/ehjqcco/qcag079](https://doi.org/10.1093%2Fehjqcco%2Fqcag079)
- **Published At:** 2026-09-16T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This systematic review and meta-analysis pooled randomized controlled trials comparing **GLP-1 receptor agonists (GLP-1RAs)** versus placebo in adults with type 2 diabetes mellitus (T2DM). - A comprehensive search of PubMed, Embase, and the Cochrane Library was performed through 31 March 2025; 20 RCTs met inclusion criteria, enrolling a total of 83,004 patients. - Primary reported benefit was a significant reduction in **major adverse cardiovascular events (MACE)** with GLP-1RAs (risk ratio 0.87, 95% CI 0.83–0.92). - GLP-1RAs were associated with lower **all-cause mortality** (RR 0.89, 95% CI 0.84–0.93) and **cardiovascular mortality** (RR 0.88, 95% CI 0.81–0.94). - Rates of **myocardial infarction** and **stroke** were reduced with GLP-1RAs (MI RR 0.87, 95% CI 0.79–0.96; stroke RR 0.88, 95% CI 0.81–0.96). - A significant reduction in the **composite renal outcome** was reported (RR 0.80, 95% CI 0.73–0.88). - Trends toward fewer heart failure hospitalizations (RR 0.93, 95% CI 0.85–1.01) and less coronary revascularization (RR 0.87, 95% CI 0.74–1.01) were observed but did not reach statistical significance. - Authors conclude GLP-1RAs provide cardioprotective and renoprotective benefits beyond glycaemic control and support guideline recommendations for use in T2DM. - Details on trial-level heterogeneity, individual agent differences, dosing, follow-up duration, and study limitations were not reported in the abstract and therefore are not summarized here.
## Clinical Analysis & Structured Key Points
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more resources ](https://pubmed.ncbi.nlm.nih.gov/42142362/#linkout) Title & authors Abstract Conflict of interest statement Comment in Similar articles Publication types MeSH terms Substances Related information LinkOut - more resources Meta-Analysis Eur Heart J Qual Care Clin Outcomes Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Eur+Heart+J+Qual+Care+Clin+Outcomes%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Eur+Heart+J+Qual+Care+Clin+Outcomes%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42142362/) . 2026 Sep 16;12(6):980-994. doi: 10.1093/ehjqcco/qcag079. # Cardiovascular and renal outcomes of GLP-1 receptor agonists in type 2 diabetes mellitus: a systematic review and meta-analysis [Mushood Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+M&cauthor_id=42142362)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-1 "Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan."), [Tallal Mushtaq Hashmi](https://pubmed.ncbi.nlm.nih.gov/?term=Hashmi+TM&cauthor_id=42142362)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-1 "Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan."), [Maryam Shahzad](https://pubmed.ncbi.nlm.nih.gov/?term=Shahzad+M&cauthor_id=42142362)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-2 "Department of Cardiology, Dow University of Health Sciences, Karachi 74200, Pakistan."), [Rohma Zia](https://pubmed.ncbi.nlm.nih.gov/?term=Zia+R&cauthor_id=42142362)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-1 "Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan."), [Hadiah Ashraf](https://pubmed.ncbi.nlm.nih.gov/?term=Ashraf+H&cauthor_id=42142362)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-1 "Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan."), [Raheel Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+R&cauthor_id=42142362)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-3 "Department of Cardiology, Royal Brompton Hospital, London SW3 6NP, UK.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-4 "National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK."), [Muhammad Rashid](https://pubmed.ncbi.nlm.nih.gov/?term=Rashid+M&cauthor_id=42142362)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-5 "Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, David Weatherall building, University Road, Keele ST5 5BG, UK."), [Stephen J Greene](https://pubmed.ncbi.nlm.nih.gov/?term=Greene+SJ&cauthor_id=42142362)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-6 "Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-7 "Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, USA."), [Robert J Mentz](https://pubmed.ncbi.nlm.nih.gov/?term=Mentz+RJ&cauthor_id=42142362)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-6 "Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-7 "Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, USA."), [Marat Fudim](https://pubmed.ncbi.nlm.nih.gov/?term=Fudim+M&cauthor_id=42142362)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-6 "Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-7 "Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, USA."), [Gregg C Fonarow](https://pubmed.ncbi.nlm.nih.gov/?term=Fonarow+GC&cauthor_id=42142362)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-8 "Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California Los Angeles, Los Angeles, CA 90095, USA."), [Jamal S Rana](https://pubmed.ncbi.nlm.nih.gov/?term=Rana+JS&cauthor_id=42142362)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-9 "Division of Cardiology, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA 94612, USA.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#full-view-affiliation-10 "Division of Research, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA 94612, USA.") Affiliations Expand ### Affiliations * 1 Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan. * 2 Department of Cardiology, Dow University of Health Sciences, Karachi 74200, Pakistan. * 3 Department of Cardiology, Royal Brompton Hospital, London SW3 6NP, UK. * 4 National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK. * 5 Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, David Weatherall building, University Road, Keele ST5 5BG, UK. * 6 Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA. * 7 Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, USA. * 8 Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California Los Angeles, Los Angeles, CA 90095, USA. * 9 Division of Cardiology, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA 94612, USA. * 10 Division of Research, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA 94612, USA. * PMID: **42142362** * DOI: [ 10.1093/ehjqcco/qcag079 ](https://doi.org/10.1093/ehjqcco/qcag079) Item in Clipboard Meta-Analysis # Cardiovascular and renal outcomes of GLP-1 receptor agonists in type 2 diabetes mellitus: a systematic review and meta-analysis Mushood Ahmed et al. Eur Heart J Qual Care Clin Outcomes. 2026. Show details Display options Display options Format Abstract PubMed PMID Eur Heart J Qual Care Clin Outcomes Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Eur+Heart+J+Qual+Care+Clin+Outcomes%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Eur+Heart+J+Qual+Care+Clin+Outcomes%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42142362/) . 2026 Sep 16;12(6):980-994. doi: 10.1093/ehjqcco/qcag079. ### Authors [Mushood Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+M&cauthor_id=42142362)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-1 "Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan."), [Tallal Mushtaq Hashmi](https://pubmed.ncbi.nlm.nih.gov/?term=Hashmi+TM&cauthor_id=42142362)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-1 "Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan."), [Maryam Shahzad](https://pubmed.ncbi.nlm.nih.gov/?term=Shahzad+M&cauthor_id=42142362)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-2 "Department of Cardiology, Dow University of Health Sciences, Karachi 74200, Pakistan."), [Rohma Zia](https://pubmed.ncbi.nlm.nih.gov/?term=Zia+R&cauthor_id=42142362)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-1 "Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan."), [Hadiah Ashraf](https://pubmed.ncbi.nlm.nih.gov/?term=Ashraf+H&cauthor_id=42142362)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-1 "Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan."), [Raheel Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+R&cauthor_id=42142362)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-3 "Department of Cardiology, Royal Brompton Hospital, London SW3 6NP, UK.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-4 "National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK."), [Muhammad Rashid](https://pubmed.ncbi.nlm.nih.gov/?term=Rashid+M&cauthor_id=42142362)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-5 "Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, David Weatherall building, University Road, Keele ST5 5BG, UK."), [Stephen J Greene](https://pubmed.ncbi.nlm.nih.gov/?term=Greene+SJ&cauthor_id=42142362)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-6 "Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-7 "Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, USA."), [Robert J Mentz](https://pubmed.ncbi.nlm.nih.gov/?term=Mentz+RJ&cauthor_id=42142362)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-6 "Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-7 "Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, USA."), [Marat Fudim](https://pubmed.ncbi.nlm.nih.gov/?term=Fudim+M&cauthor_id=42142362)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-6 "Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-7 "Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, USA."), [Gregg C Fonarow](https://pubmed.ncbi.nlm.nih.gov/?term=Fonarow+GC&cauthor_id=42142362)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-8 "Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California Los Angeles, Los Angeles, CA 90095, USA."), [Jamal S Rana](https://pubmed.ncbi.nlm.nih.gov/?term=Rana+JS&cauthor_id=42142362)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-9 "Division of Cardiology, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA 94612, USA.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42142362/#short-view-affiliation-10 "Division of Research, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA 94612, USA.") ### Affiliations * 1 Department of Cardiology, Rawalpindi Medical University, Rawalpindi 46000, Pakistan. * 2 Department of Cardiology, Dow University of Health Sciences, Karachi 74200, Pakistan. * 3 Department of Cardiology, Royal Brompton Hospital, London SW3 6NP, UK. * 4 National Heart and Lung Institute, Imperial College London, London SW7 2AZ, UK. * 5 Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, David Weatherall building, University Road, Keele ST5 5BG, UK. * 6 Division of Cardiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA. * 7 Division of Research, Duke Clinical Research Institute, 2301 Erwin Road, Durham, NC, USA. * 8 Ahmanson-UCLA Cardiomyopathy Center, Division of Cardiology, University of California Los Angeles, Los Angeles, CA 90095, USA. * 9 Division of Cardiology, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA 94612, USA. * 10 Division of Research, Kaiser Permanente Northern California, 1 Kaiser Plaza, Oakland, CA 94612, USA. * PMID: **42142362** * DOI: [ 10.1093/ehjqcco/qcag079 ](https://doi.org/10.1093/ehjqcco/qcag079) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Aims:** Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a foundational therapeutic option for type 2 diabetes mellitus (T2DM), offering glycaemic control and cardiovascular benefits. This systematic review and meta-analysis evaluate the impact of GLP-1RAs on cardiovascular outcomes in patients with T2DM. **Methods and results:** We conducted a comprehensive search of PubMed, Embase, and Cochrane Library up to 31 March 2025, for randomized controlled trials (RCTs) comparing GLP-1RAs with placebo in T2DM patients. Risk ratios (RR) with 95% confidence intervals (CIs) were pooled using a random-effects model. Twenty RCTs involving 83 004 patients were included. GLP-1RAs significantly reduced the risk of major adverse cardiovascular events (RR 0.87, 95% CI 0.83-0.92), all-cause death (RR 0.89, 95% CI 0.84-0.93), cardiovascular death (RR 0.88, 95% CI 0.81-0.94), myocardial infarction (RR 0.87, 95% CI 0.79-0.96), stroke (RR 0.88, 95% CI 0.81-0.96) and composite renal outcome (RR 0.80, 95% CI 0.73-0.88) compared to placebo. In addition, a trend of reduction in heart failure hospitalizations (RR 0.93, 95% CI 0.85-1.01), and coronary revascularization (RR = 0.87, 95% CI 0.74 to 1.01) was observed with GLP-1 RAs without reaching statistical significance. **Conclusion:** GLP-1RAs are associated with improved cardiovascular outcomes in patients with T2DM. These findings support current guideline recommendations and highlight their cardioprotective benefits beyond glycaemic control in patients with T2DM. **Keywords:** Cardiovascular outcomes; GLP-1 receptor agonists; Meta-analysis; Type 2 diabetes. © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology
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