# Semaglutide verlaagt cardiovasculaire sterfte met 17% — meta-analyse

*geplaatst 2026-11-10 · Nierziekte · Critical pathways in cardiology · doi 10.1097/HPC.0000000000000445 · https://hartvaat.nl/2026/11/02/semaglutide-verlaagt-cardiovasculaire-sterfte-met-17-meta-analyse/*

Deze meta-analyse van zeven RCT’s met in totaal 38.412 patiënten onderzocht het effect van semaglutide op cardiovasculaire sterfte bij patiënten met type 2-diabetes, overgewicht/obesitas en HFpEF. Semaglutide leidde tot een significante daling van het risico op cardiovasculaire dood met 17% (HR 0,83; 95% BI 0,72-0,95; p=0,01), met een consistent effect over verschillende subgroepen en toedieningsroutes. De bevindingen ondersteunen de rol van semaglutide als brede cardioprotectieve interventie, onafhankelijk van de basale glykemische status.

## English: Semaglutide and Cardiovascular Death: a Systematic Review and Meta-Analysis Cardioprotective Efficacy of Semaglutide.

This meta-analysis of seven RCTs involving 38,412 patients evaluated the impact of semaglutide on cardiovascular mortality across type 2 diabetes, overweight/obesity, and HFpEF populations. Semaglutide significantly reduced the risk of cardiovascular death by 17% compared with placebo (HR 0.83; 95% CI 0.72-0.95; p=0.01), with consistent benefits across different clinical phenotypes and administration routes. These findings reinforce semaglutide’s position as a broad cardioprotective therapy, independent of baseline glycemic control.

## Abstract (original, from the publication)

BACKGROUND: Cardiovascular death (CVD) remains a leading cause of global mortality. Although semaglutide reduces major adverse cardiovascular events (MACE), the consistency and exact magnitude of its standalone effect on CVD across various patient phenotypes require comprehensive evaluation. This meta-analysis systematically evaluated the clinical efficacy of semaglutide on CVD risk across randomized controlled trials (RCTs). METHODS: PubMed, Embase, and ClinicalTrials.gov were searched up to July 2026 to identify RCTs comparing semaglutide with placebo in adults with type 2 diabetes mellitus (T2DM), overweight or obesity, heart failure with preserved ejection fraction (HFpEF) or chronic kidney disease, reporting CVD as a primary, secondary or exploratory outcome. Pooled hazard ratio (HR) and 95% confidence intervals (CI) were calculated using a random-effects restricted maximum likelihood (REML) model. Publication bias and study robustness were assessed via Egger's test, Begg's test, and trim-and-fill analysis. RESULTS: Seven high-quality RCTs comprising 38412 patients were included. Semaglutide significantly reduced the risk of CVD by 17% compared with placebo (pooled HR = 0.83, 95% CI: 0.72-0.95; P = 0.01). Inter-study heterogeneity was low-to-moderate (I 2= 27.44%, P = 0.18). Subgroup analyses confirmed uniform benefits across different clinical phenotypes (T2DM; overweight or obesity without diabetes; and obesity-related HFpEF, with or without T2DM; P = 0.63) and administration routes (oral versus subcutaneous; P = 0.74). Meta-regression identified trial duration as a key moderator (R 2 = 85.27%, P = 0.089), whereas sex, age, BMI, HbA1c and concomitant SGLT2i therapy did not modify the treatment effect. Publication bias tests were non-significant, and trim-and-fill simulations confirmed the stability of the primary pooled estimate. CONCLUSION: Semaglutide delivers a robust and consistent 17% reduction in CVD across diverse cardiometabolic populations, including patients with T2DM, overweight or obesity without diabetes, and obesity-related HFpEF. These findings strongly support its role as a foundational cardioprotective intervention, independent of baseline glycemic status or the administration route.

Auteurs: Gaetano Marino, Stefano Aquilani, Stefania Angela Di Fusco, Antonio Concistrè, Federico Nardi, Domenico Gabrielli, Giuseppe Imperoli, Furio Colivicchi

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Bron: Critical pathways in cardiology, https://doi.org/10.1097/HPC.0000000000000445. Bijgewerkt 2026-11-03T02:34:15Z. 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.