Effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events in patients with Type 2 diabetes mellitus with or without established cardiovascular disease: a meta-analysis of randomized controlled trials

This meta-analysis (n=56,004) found GLP-1 receptor agonists were associated with a reduction in major adverse cardiovascular events (HR 0.88, 95% CI 0.80–0.96) with no statistically significant difference between patients with established CVD and those with risk factors only.

SPS commentary:

This trial-level meta-analysis used data from seven placebo-controlled cardiovascular outcome trials of GLP-1 receptor agonists in patients with type 2 diabetes mellitus. As well as a reduction in MACE (number needed to treat [NNT] to prevent one MACE event of 73 (95% CI 45–212), the report notes there was an observed reduction in total (NNT 118; 95% CI 69–494) and CV mortality (NNT 170; 95% CI 98–908), stroke (NNT 211; 95% CI 136–549; not shown in previous analyses), and hospitalisation for heart failure (NNT 300; 95% CI 181–1004), with a trend for reduction of MI.  

The authors acknowledge a number of limitations to their analysis, including the use of aggregate data (trial level as opposed to patient-level; limiting the possibility to investigate subgroups), the relatively short follow-up of some of the included studies, and the fact that the potential for publication bias was not evaluated formally.

European Heart Journal