Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safety
Abstract Background Glucagon like peptide-1 receptor agonist (GLP-1RA) use in individuals with high atherosclerotic cardiovascular disease (ASCVD) risk reduces major adverse cardiovascular events (MACE). However, its clinical impact, in terms of numbers needed to treat (NNT), efficacy and safety pro...
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BMC
2025-07-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-025-02840-3 |
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| author | Ansel Shao Pin Tang Jovan Teng Yuan Hsu Sheena Kar Shuan Chong Jingxuan Quek Genevieve Shek Farisah Sulaimi Kai En Chan Vickram Vijay Anand Bryan Chong Anurag Mehta Sue-Anne Toh Mark Muthiah Georgios K. Dimitriadis Carel W. le Roux Mark Yan-Yee Chan Mamas Andreas Mamas Yip Han Chin Nicholas W. S. Chew |
| author_facet | Ansel Shao Pin Tang Jovan Teng Yuan Hsu Sheena Kar Shuan Chong Jingxuan Quek Genevieve Shek Farisah Sulaimi Kai En Chan Vickram Vijay Anand Bryan Chong Anurag Mehta Sue-Anne Toh Mark Muthiah Georgios K. Dimitriadis Carel W. le Roux Mark Yan-Yee Chan Mamas Andreas Mamas Yip Han Chin Nicholas W. S. Chew |
| author_sort | Ansel Shao Pin Tang |
| collection | DOAJ |
| description | Abstract Background Glucagon like peptide-1 receptor agonist (GLP-1RA) use in individuals with high atherosclerotic cardiovascular disease (ASCVD) risk reduces major adverse cardiovascular events (MACE). However, its clinical impact, in terms of numbers needed to treat (NNT), efficacy and safety profile in reducing the risk of myocardial infarction (MI) and the individual ASCVD constituents remain unclear. Methods Electronic databases, Medline and Embase were reviewed for randomized trials from inception to 29 May 2025. Risk-reduction effect of GLP-1RA were pooled using pairwise meta-analysis with random-effects model. The primary outcome was MI, and secondary outcomes were the individual ASCVD constituents. Results 109,846 patients from 25 unique studies were included. Over a follow-up duration of 3.48 ± 1.51 (1.55 to 5.47) years, GLP-1RA reduced the risk of total MI (RR: 0.86, p < 0.01), with numbers needed to benefit (NNTB) of 207 to prevent one event of MI. Higher body mass index was associated with greater MI risk reduction (β: -0.09, p = 0.03) in GLP-1RA users. GLP-1RA reduced cardiovascular mortality (RR: 0.87, p < 0.01, NNTB 170), MACE (RR: 0.87, p < 0.01, NNTB 67) and stroke (RR: 0.88, p < 0.01, NNTB 335) compared to placebo. GLP-1RA commonly resulted in gastrointestinal side-effects amongst other systems (RR: 1.55, p < 0.01, NNTH 9). Conclusion GLP-1RA reduced the risk of MI, stroke, cardiovascular mortality and MACE in a broad range of patients with and without T2DM and/or prior ASCVD, supporting its role in ASCVD prevention, especially in the cohort with high BMI. Trial registration: Open Science Framework ( https://doi.org/10.17605/OSF.IO/7VXN5 ). Graphical Abstract |
| format | Article |
| id | doaj-art-fcf718d9950049a080b083fdbbb51c5c |
| institution | Kabale University |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | Cardiovascular Diabetology |
| spelling | doaj-art-fcf718d9950049a080b083fdbbb51c5c2025-08-20T03:45:40ZengBMCCardiovascular Diabetology1475-28402025-07-0124111810.1186/s12933-025-02840-3Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safetyAnsel Shao Pin Tang0Jovan Teng Yuan Hsu1Sheena Kar Shuan Chong2Jingxuan Quek3Genevieve Shek4Farisah Sulaimi5Kai En Chan6Vickram Vijay Anand7Bryan Chong8Anurag Mehta9Sue-Anne Toh10Mark Muthiah11Georgios K. Dimitriadis12Carel W. le Roux13Mark Yan-Yee Chan14Mamas Andreas Mamas15Yip Han Chin16Nicholas W. S. Chew17NUS Yong Loo Lin School of Medicine, National University of SingaporeNUS Yong Loo Lin School of Medicine, National University of SingaporeNUS Yong Loo Lin School of Medicine, National University of SingaporeNUS Yong Loo Lin School of Medicine, National University of SingaporeWallace Wurth, University of New South WalesWallace Wurth, University of New South WalesNUS Yong Loo Lin School of Medicine, National University of SingaporeLee Kong Chian School of Medicine, Nanyang Technological UniversityNUS Yong Loo Lin School of Medicine, National University of SingaporeVirginia Commonwealth University Health Pauley Heart Center, Division of Cardiology (A.M.), Department of Internal Medicine, Virginia Commonwealth University School of MedicineNUS Yong Loo Lin School of Medicine, National University of SingaporeDivision of Gastroenterology and Hepatology, Department of Medicine, National University HospitalDepartment of Endocrinology ASO/EASO COM, King’s College Hospital NHS Foundation TrustDiabetes Complications Research Centre, Conway Institute, University College DublinNUS Yong Loo Lin School of Medicine, National University of SingaporeKeele Cardiac Research Group, Keele UniversityMinistry of Health Holdings, Ministry of HealthNUS Yong Loo Lin School of Medicine, National University of SingaporeAbstract Background Glucagon like peptide-1 receptor agonist (GLP-1RA) use in individuals with high atherosclerotic cardiovascular disease (ASCVD) risk reduces major adverse cardiovascular events (MACE). However, its clinical impact, in terms of numbers needed to treat (NNT), efficacy and safety profile in reducing the risk of myocardial infarction (MI) and the individual ASCVD constituents remain unclear. Methods Electronic databases, Medline and Embase were reviewed for randomized trials from inception to 29 May 2025. Risk-reduction effect of GLP-1RA were pooled using pairwise meta-analysis with random-effects model. The primary outcome was MI, and secondary outcomes were the individual ASCVD constituents. Results 109,846 patients from 25 unique studies were included. Over a follow-up duration of 3.48 ± 1.51 (1.55 to 5.47) years, GLP-1RA reduced the risk of total MI (RR: 0.86, p < 0.01), with numbers needed to benefit (NNTB) of 207 to prevent one event of MI. Higher body mass index was associated with greater MI risk reduction (β: -0.09, p = 0.03) in GLP-1RA users. GLP-1RA reduced cardiovascular mortality (RR: 0.87, p < 0.01, NNTB 170), MACE (RR: 0.87, p < 0.01, NNTB 67) and stroke (RR: 0.88, p < 0.01, NNTB 335) compared to placebo. GLP-1RA commonly resulted in gastrointestinal side-effects amongst other systems (RR: 1.55, p < 0.01, NNTH 9). Conclusion GLP-1RA reduced the risk of MI, stroke, cardiovascular mortality and MACE in a broad range of patients with and without T2DM and/or prior ASCVD, supporting its role in ASCVD prevention, especially in the cohort with high BMI. Trial registration: Open Science Framework ( https://doi.org/10.17605/OSF.IO/7VXN5 ). Graphical Abstracthttps://doi.org/10.1186/s12933-025-02840-3GLP-1 receptor agonistGLP-1RAMyocardial infarctionStrokeCardiovascular mortalityCardiovascular disease |
| spellingShingle | Ansel Shao Pin Tang Jovan Teng Yuan Hsu Sheena Kar Shuan Chong Jingxuan Quek Genevieve Shek Farisah Sulaimi Kai En Chan Vickram Vijay Anand Bryan Chong Anurag Mehta Sue-Anne Toh Mark Muthiah Georgios K. Dimitriadis Carel W. le Roux Mark Yan-Yee Chan Mamas Andreas Mamas Yip Han Chin Nicholas W. S. Chew Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safety Cardiovascular Diabetology GLP-1 receptor agonist GLP-1RA Myocardial infarction Stroke Cardiovascular mortality Cardiovascular disease |
| title | Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safety |
| title_full | Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safety |
| title_fullStr | Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safety |
| title_full_unstemmed | Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safety |
| title_short | Glucagon-like peptide-1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction: a comprehensive meta-analysis of number needed to treat, efficacy and safety |
| title_sort | glucagon like peptide 1 receptor agonist in myocardial infarction and atherosclerotic cardiovascular disease risk reduction a comprehensive meta analysis of number needed to treat efficacy and safety |
| topic | GLP-1 receptor agonist GLP-1RA Myocardial infarction Stroke Cardiovascular mortality Cardiovascular disease |
| url | https://doi.org/10.1186/s12933-025-02840-3 |
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