{"id":"bec9b090e3c8","type":"article","url":"https://hartvaat.nl/2026/05/25/semaglutide-verlaagt-mortaliteit-cv-events-en-nierschade-in-alle-stadia-van-ckm-/","title":"Semaglutide verlaagt mortaliteit, CV-events én nierschade in alle stadia van CKM-syndroom: meta-analyse van 39.204 patiënten","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","huisarts","internist"],"tags":["flow-trial","select-trial","soul-trial","stride-trial"],"journal":"Cardiovascular diabetology","doi":"10.1186/s12933-026-03215-y","source_url":"https://doi.org/10.1186/s12933-026-03215-y","authors":["Federica Marzano","Stefania Paolillo","Paola Gargiulo","Ciro Cotticelli","Mariafrancesca Di Santo","Ermanno Nardi","Giuseppe Maria Abbellito","Laura Liccardi","Fabrizio Perrone Filardi","Dario Bruzzese","Pasquale Perrone Filardi"],"significance":8,"published":"2026-06-04","source_date":"2026-05-25","image":"https://hartvaat.nl/global/img/f7f917f50a2d.webp","kennis":["https://hartvaat.nl/kennis/farmacologie/glp1-agonisten-cardiologie/","https://hartvaat.nl/kennis/farmacologie/colchicine-cardiovasculair/"],"congress":"","summary_en":"Systematic review and meta-analysis of 8 randomised trials (39,204 patients) on semaglutide versus placebo across the full cardio-kidney-metabolic (CKM) spectrum. Semaglutide significantly reduced all-cause mortality (HR 0.84; 95% CI 0.77-0.92), cardiovascular mortality (HR 0.83), MACE (HR 0.82), non-fatal myocardial infarction (HR 0.75), worsening heart failure (HR 0.84) and adverse kidney outcomes (HR 0.83). No significant effect on non-fatal stroke. The breadth of CKM benefit — kidney, heart and mortality together — distinguishes semaglutide from many other classes and aligns with the recognition of CKM as an integrated disease entity.","created":"2026-07-03T10:32:59Z","updated":"2026-07-03T13:31:54Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Systematische review en meta-analyse van 8 gerandomiseerde studies (39.204 patiënten) over semaglutide versus placebo in het volledige cardiovasculair-renaal-metabool (CKM) spectrum. Semaglutide verlaagde significant: totale mortaliteit (HR 0,84; 95%-BI 0,77-0,92), cardiovasculaire mortaliteit (HR 0,83), MACE (HR 0,82), niet-fataal myocardinfarct (HR 0,75), verergerend hartfalen (HR 0,84) en nierschade-uitkomsten (HR 0,83). Geen significant effect op niet-fataal CVA. De brede CKM-werking — winst op nier, hart én sterfte tegelijk — onderscheidt semaglutide van veel andere klassen en sluit aan bij de erkenning van CKM als geïntegreerd ziektebeeld.","abstract_original":"BACKGROUND: Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated cardiometabolic benefits in randomized controlled trials (RCTs). However, its overall effects on mortality, cardiovascular (CV) and kidney outcomes have not been comprehensively synthesized. This meta-analysis aimed to assess the prognostic impact of semaglutide across the cardio-kidney-metabolic continuum. METHODS: A systematic literature search was conducted to identify all eligible RCTs comparing the prognostic effects of semaglutide with placebo across diverse patient populations. Primary outcomes were all-cause and CV mortality. Secondary outcomes included major CV and kidney events, while major adverse limb events (MALE) were analyzed as an exploratory endpoint. A random-effects model was used to pool hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Eight trials encompassing 39,204 patients were included. In patients treated with semaglutide a significant reduction of all-cause (HR, 0.84; 95% CI, 0.77-0.92; p = 0.0001) and CV mortality (HR, 0.83; 95% CI, 0.72-0.95; p = 0.0078), major adverse CV events (MACE, HR, 0.82; 95% CI, 0.77-0.87; p < 0.0001), nonfatal myocardial infarction (MI, HR, 0.75; 95% CI, 0.68-0.84; p < 0.0001), worsening heart failure (HF, HR, 0.84; 95% CI, 0.73-0.98; p = 0.0245), and kidney outcomes (HR, 0.83; 95% CI, 0.73-0.95; p = 0.0080) was observed compared to placebo. No significant effects were observed for nonfatal stroke. CONCLUSIONS: Treatment with semaglutide, compared to placebo, is associated with significant lower incidence of all-cause and CV mortality, as well major CV and kidney events across the continuum of cardio-kidney-metabolic syndrome."}