Evidence map›Paper›PMID 40652242›Full record

SynthesisCardiovascular diabetology2025

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.

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 and 8 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Ansel Shao Pin Tang *NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Jovan Teng Yuan Hsu *NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Sheena Kar Shuan Chong *NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Jingxuan QuekNUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Genevieve ShekWallace Wurth, University of New South Wales, Sydney, NSW, Australia.
Farisah SulaimiWallace Wurth, University of New South Wales, Sydney, NSW, Australia.
Kai En ChanNUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Vickram Vijay AnandLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Bryan ChongNUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Anurag MehtaVirginia Commonwealth University Health Pauley Heart Center, Division of Cardiology (A.M.), Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, USA.
Sue-Anne TohNUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Mark MuthiahDivision of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.
Georgios K DimitriadisDepartment of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, London, UK.
Carel W le RouxDiabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland.
Mark Yan-Yee ChanNUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Mamas Andreas Mamas *Keele Cardiac Research Group, Keele University, Stoke-on-Trent, UK.
Yip Han Chin *Ministry of Health Holdings, Ministry of Health, Singapore, Singapore.
Nicholas W S Chew *NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. Nicholas_WS_Chew@nuhs.edu.sg.ORCID 0000-0002-0640-0430

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlucagon 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.

methodsElectronic 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.

results109,846 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).

conclusionGLP-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 registrationOpen Science Framework ( https://doi.org/10.17605/OSF.IO/7VXN5 ).

Indexed as

AtherosclerosisDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsIncretinsMyocardial InfarctionNumbers Needed To TreatAgedFemaleGlucagon-Like Peptide-1 ReceptorHeart Disease Risk FactorsHumansMaleMiddle AgedProtective FactorsRandomized Controlled Trials as TopicGLP1R protein, humanGlucagon-Like Peptide-1 ReceptorGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsIncretinsCardiovascular diseaseCardiovascular mortalityGLP-1RAGLP-1 receptor agonistMyocardial infarctionNumbers-needed-to-treatStroke

Identifiers

PMID40652242
PMCPMC12255114

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.