Cardiometabolic & kidneyMeta-analysis
Glucagon-like peptide-1 receptor agonists for prevention of heart failure events in type 2 diabetes and/or obesity
- meta-analysis
- random effects
- Mantel-Haenszel Method
Authors' conclusion
GLP-1 receptor agonists have limited absolute benefit for preventing HF events in patients with type 2 diabetes and/or obesity, including in those without baseline HF.
Study context
- Population
- Patients with type 2 diabetes and/or obesity in placebo-controlled randomized controlled trials (RCTs) of GLP-1 receptor agonists with a prespecified heart failure (HF) event endpoint
- Participants
- 95,023 Twelve placebo-controlled RCTs
- Comparison
- GLP-1 receptor agonists vs placebo
Pooled result
As reported in the abstract
HF events
Each group vs placeboEstimate (95% CI)
GLP-1 receptor agonists
RR 0.88(0.82–0.95)
GLP-1 receptor agonists
ARR 0.42%(0.17%–0.62%)
- GLP-1 receptor agonists
- NNT 238 (95% CI 161–588)
- reduced HF events by
- 12%
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| HF events, without baseline HF — GLP-1 receptor agonists vs placebo | RR 0.81 (95% CI 0.72–0.90) | |
| HF events, without baseline HF — GLP-1 receptor agonists vs placebo | ARR 0.60% (95% CI 0.32%–0.89%) | |
| HF events, semaglutide — Semaglutide vs placebo | RR 0.84 (95% CI 0.74–0.95) | |
| HF events, semaglutide — Semaglutide vs placebo | ARR 0.62% (95% CI 0.19%–1.00%) | |
| HF events, semaglutide, without baseline HF — Semaglutide vs placebo | RR 0.69 (95% CI 0.55–0.88) | |
| HF events, semaglutide, without baseline HF — Semaglutide vs placebo | ARR 1.25% (95% CI 0.48%–1.82%) | |
| 0.20.5125Ratio (log scale) |
| Outcome | NNT (95% CI) |
|---|---|
| HF events, without baseline HF — GLP-1 receptor agonists vs placebo | 167 (113–313) |
| HF events, semaglutide — Semaglutide vs placebo | 161 (100–526) |
| HF events, semaglutide, without baseline HF — Semaglutide vs placebo | 80 (55–208) |
- HF events, without baseline HF — reduced HF events by
- 19%
- HF events, semaglutide — reduced the risk of HF events by
- 16%
- HF events, semaglutide, without baseline HF — reduced the risk of HF events by
- 31%
Original publication
Glucagon-like peptide-1 receptor agonists for prevention of heart failure events in type 2 diabetes and/or obesity. ESC Heart Fail. Published 25 March 2026. doi:10.1093/eschf/xvag091
Summarised from the published abstract; every number is checked against it