Key result
GLP1-RAs reduce MACE by ~19% in patients without obesity.
Why the study?
Do GLP1-RAs reduce cardiovascular events in individuals without obesity?
Meta-Analysis (n=91,167)
Do GLP1-RAs reduce cardiovascular events in individuals without obesity?
GLP1-RAs significantly reduce MACE and CV death in individuals regardless of obesity status, supporting their use for broader cardiometabolic prevention beyond weight management.
Answers are grounded in this paper and cite their sources.
Supports GLP1-RA use for MACE prevention beyond obesity; extends cardiometabolic benefits independent of weight loss.
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP1-RAs) improve cardiometabolic health in patients with obesity and/or type 2 diabetes mellitus. However, their role in cardio protection in individuals without obesity (BMI < 30 kg/m²) remains unclear. This study aimed to determine whether GLP1-RAs reduce cardiovascular events in individuals without obesity. METHODS: A systematic review and meta-analysis of RCTs evaluating GLP1-RAs in obese (BMI ≥ 30 kg/m²) and non-obese (BMI < 30 kg/m²) individuals was conducted. The analyzed outcomes included major adverse cardiovascular events (MACE), cardiovascular (CV) death, and heart failure hospitalization (HFH). Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. The study was conducted according to a prespecified protocol registered in PROSPERO (CRD4201287112). RESULTS: Twelve RCTs comprising 91,167 participants were included. BMI subgroup population counts were available in 10 of the 12 included trials. In patients without obesity, GLP1-RAs significantly reduced MACE (HR = 0.81 [0.72-0.90]; CONCLUSION: GLP1-RAs reduce MACE and CV death in individuals irrespective of the obesity status. These findings support expanding GLP1-RA use beyond weight management to broader cardiometabolic prevention, though long-term data in healthy weight and lower-risk populations are warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-026-01969-6.
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Waqas et al. (2026) conducted a meta-analysis in Individuals with and without obesity (n=91,167). Glucagon-like peptide-1 receptor agonists (GLP1-RAs) was evaluated on Major adverse cardiovascular events (MACE) (HR 0.81, 95% CI 0.72-0.90). In patients without obesity, GLP1-RAs significantly reduced major adverse cardiovascular events (HR 0.81; 95% CI 0.72-0.90).
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