CARDIOVASCULAR BENEFITS OF GLP-1 RECEPTOR AGONISTS: EVIDENCE FROM CARDIOVASCULAR OUTCOMES TRIALS (CVOTs)

Nicol Szerenos; Natalia Woroniecka; Daria Trocka; Alicja Kozłowska; Karolina Przybysz; Luiza Stadnik; Natalia Zienkiewicz; Jarosław Rachoń; Adela  Dzwonkowska; Jakub Dzwonkowski

doi:10.31435/ijitss.3(51).2026.6150

Authors

Nicol Szerenos Szpital Morski im. PCK, Gdynia, Poland https://orcid.org/0009-0009-2754-8344
Natalia Woroniecka Samodzielny Publiczny Zakład Opieki Zdrowotnej MSWiA w Gdańsku, Poland https://orcid.org/0009-0006-4713-4526
Daria Trocka Szpital św. Wojciecha w Gdańsku, Gdańsk, Poland https://orcid.org/0000-0001-9684-5881
Alicja Kozłowska Szpital Morski im. PCK, Gdynia, Poland https://orcid.org/0009-0000-5991-7401
Karolina Przybysz Szpital Morski im. PCK, Gdynia, Poland https://orcid.org/0009-0002-9001-829X
Luiza Stadnik Szpital św. Wojciecha Copernicus PL Sp. z o.o., Gdańsk, Poland https://orcid.org/0009-0009-6854-4905
Natalia Zienkiewicz Szpital Morski im. PCK, Gdynia, Poland https://orcid.org/0009-0009-3380-0470
Jarosław Rachoń Uniwersyteckie Centrum Kliniczne, Gdańsk, Poland https://orcid.org/0009-0007-9691-2221
Adela Dzwonkowska Szpitale Tczewskie S.A., Tczew, Poland https://orcid.org/0009-0004-7026-7437
Jakub Dzwonkowski Szpital Wojewódzki im. Mikołaja Kopernika, Koszalin, Poland https://orcid.org/0009-0006-5087-0698

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6150

Keywords:

GLP-1 Receptor Agonists; Type 2 Diabetes Mellitus; Cardiovascular Outcomes; Cardiovascular Disease; Obesity; Semaglutide

Abstract

Cardiovascular disease remains the leading cause of morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). In recent years, glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as an important therapeutic class capable of providing cardiovascular benefits beyond glycemic control. This review aimed to evaluate the current evidence regarding the cardiovascular effects of GLP-1RAs, with particular emphasis on findings from major cardiovascular outcome trials (CVOTs).

A narrative review of randomized controlled trials, meta-analyses, and contemporary clinical guidelines was conducted. Major CVOTs evaluating lixisenatide, liraglutide, semaglutide, exenatide, albiglutide, dulaglutide, oral semaglutide, and efpeglenatide were analyzed with respect to major adverse cardiovascular events (MACE), cardiovascular mortality, stroke, myocardial infarction, heart failure, and renal outcomes.

The available evidence demonstrates that several GLP-1RAs significantly reduce cardiovascular risk in patients with T2DM. Liraglutide, semaglutide, dulaglutide, albiglutide, and efpeglenatide consistently showed reductions in MACE, while meta-analyses confirmed favorable effects on cardiovascular mortality, all-cause mortality, and stroke. Additional benefits included improved renal outcomes and clinically meaningful weight loss. Recent evidence from the SELECT trial further suggests that cardiovascular protection may extend to individuals with overweight or obesity without diabetes.

In conclusion, GLP-1 receptor agonists have evolved from glucose-lowering agents into therapies with established cardioprotective properties. Their ability to improve cardiovascular outcomes and reduce cardiometabolic risk supports their central role in contemporary diabetes management and cardiovascular prevention strategies.

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