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Cardiovascular Benefits of GLP-1 Receptor Agonists in Patients Living with Obesity or Overweight: A Meta-analysis of Randomized Controlled Trials

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A Commentary to this article was published on 15 May 2024

Abstract

Background

GLP-1 receptor agonists (GLP-1 RAs) have emerged as an effective therapeutic class for weight loss. However, the efficacy of these agents in reducing cardiovascular endpoints among patients living with obesity or overweight is unclear.

Methods

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing GLP-1 RAs versus placebo in patients with obesity or overweight. We searched PubMed, Cochrane, and Embase databases. A random-effects model was used to calculate risk ratios (RRs) and mean differences (MDs), with 95% confidence intervals (CIs).

Results

A total of 13 RCTs were included, with 30,512 patients. Compared with placebo, GLP-1 RAs reduced systolic blood pressure (MD − 4.76 mmHg; 95% CI − 6.03, − 3.50; p < 0.001; I2 = 100%) and diastolic blood pressure (MD − 1.41 mmHg; 95% CI − 2.64, − 0.17; p = 0.03; I2 = 100%). GLP-1 RA significantly reduced the occurrence of myocardial infarction (RR 0.72; 95% CI 0.61, 0.85; p < 0.001; I2 = 0%). There were no significant differences between groups in unstable angina (UA; RR 0.84; 95% CI 0.65, 1.07; p = 0.16; I2 = 0%), stroke (RR 0.91; 95% CI 0.74, 1.12; p = 0.38; I2 = 0%), atrial fibrillation (AF; RR 0.49; 95% CI 0.17, 1.43; p = 0.19; I2 = 22%), and deep vein thrombosis (RR 0.30; 95% CI 0.06, 1.40; p = 0.13; I2 = 0%).

Conclusions

In patients living with obesity or overweight, GLP-1 RA reduced systolic and diastolic blood pressure and the occurrence of myocardial infarction, with a neutral effect on the occurrence of UA, stroke, AF, and deep vein thrombosis.

Registration

PROSPERO identifier number CRD42023475226.

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Authors and Affiliations

  1. Department of Medicine, Federal University of Triângulo Mineiro, Frei Paulino street, n 30, Uberaba, Minas Gerais, Brazil

    Gustavo de Oliveira Almeida, Júlia Braga Cintra, Henrique Champs Porfírio Carvalho, Ana Laura Soares Silva, Júlia Camargo Kabariti & Bárbara Silvestre Minucci

  2. Department of Medicine, University of South Santa Catarina, Palhoça, Santa Catarina, Brazil

    Thiago Faraco Nienkötter & Edmundo Damiani Bertoli

  3. Department of Medicine, Amazonas State University, Manaus, Amazonas, Brazil

    Caroline Cristine Almeida Balieiro

  4. Department of Medicine, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil

    Eric Pasqualotto

  5. Department of Cardiology, Dante Pazzanese Institute of Cardiology, São Paulo, São Paulo, Brazil

    Camila Mota Guida

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Correspondence to Gustavo de Oliveira Almeida.

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Gustavo de Oliveira Almeida, Thiago Faraco Nienkötter, Caroline Cristine Almeida Balieiro, Eric Pasqualotto, Júlia Braga Cintra, Henrique Champs Porfírio Carvalho, Ana Laura Soares Silva, Edmundo Damiani Bertoli, Bárbara Silvestre Minucci, Julia Camargo Kabariti, and Camila Mota Guida declare that they have no potential conflicts of interest that might be relevant to the contents of this manuscript.

Authors’ Contributions

GOA, TFN, CCAB, JBC, HCPC, ALSS, EDB, JCK, and BSM participated in the literature search, data curation, data analysis, and drafting of the original manuscript. GO and CG participated in content guidance and critical revision of the paper for important intellectual content. CG and EP supervised the work and revised the article critically. The manuscript has not been previously published in its entirety or in part in any language, and all authors have read and approved its submission.

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de Oliveira Almeida, G., Nienkötter, T.F., Balieiro, C.C.A. et al. Cardiovascular Benefits of GLP-1 Receptor Agonists in Patients Living with Obesity or Overweight: A Meta-analysis of Randomized Controlled Trials. Am J Cardiovasc Drugs (2024). https://doi.org/10.1007/s40256-024-00647-3

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