Evidence Intelligence™
- ImpactScore™
- 25
- Negative
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerResumen de Investigación
Analyzed using Evidence Intelligence™
HbA1c mediates cardiovascular benefits of GLP-1 receptor agonists
Última actualización 8 de julio de 2026
Key finding
Total effect of liraglutide on 3P-MACE was -0.0177.
This study investigated the effects of GLP-1 receptor agonists, liraglutide and semaglutide, on cardiovascular outcomes in diabetes, finding significant reductions in major adverse cardiovascular events.
Quick read
Study at a glance
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Extended (5–20+ y)
Risk of bias
High Risk
Guarda este estudio en tu Evidence Tracker para encontrarlo facilmente cuando lo necesites.
Plain-language summary
What this paper says
A plain-language read of the study's main message and where it applies.
Study focus
This study investigated the effects of GLP-1 receptor agonists, liraglutide and semaglutide, on cardiovascular outcomes in diabetes, finding significant reductions in major adverse cardiovascular events.
Clinical relevance
These findings are crucial as they highlight the cardiovascular benefits of GLP-1 receptor agonists for diabetes patients, which can inform treatment decisions and improve patient outcomes. Reducing major cardiovascular events can lead to better overall health and longevity for individuals living with diabetes.
Keep in mind
The effectiveness of the interventions remains unclear due to unspecified p-values. Potential limitations in generalizability due to the specific population studied. Lack of detailed information on long-term outcomes beyond the study duration.
Published in
Referencia de la Revista
Publication details and source links for this paper.
Zi-Yang P, Yu-Hsuan L, Huang-Tz O, Shihchen K. Causal mediation analysis of GLP-1 receptor agonists on cardiovascular outcomes in diabetes. Cardiovascular Diabetology. 2025;24:465. doi:10.1186/s12933-025-03007-w
Efectos Principales
Liraglutide significantly reduced the incidence of nonfatal stroke and myocardial infarction, as well as cardiovascular death compared to placebo.
HbA1c contributed 38.2% to liraglutide's effect on 3P-MACE.
Semaglutide significantly reduced the incidence of nonfatal stroke and myocardial infarction, as well as cardiovascular death compared to placebo.
HbA1c contributed 51.8% to semaglutide's effect on 3P-MACE.
Evidence network
How this study fits
Understand where this research contributes within the broader evidence network.
Evidence Context
This study contributes evidence to Liraglutide, Semaglutide and Cardiovascular death, Composite cardiovascular events (CV death, MI, stroke, HF hospitalization), Incidence of myocardial infarction, and 1 more.
This study contributes evidence to
Primary intervention
Liraglutide
Primary outcomes
- Cardiovascular death
- Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
- Incidence of myocardial infarction
Evidence topics
Primary intervention
Evidence relationships
Intervention and outcome relationships this study adds to the evidence network.
8
Evidence pairs
8
Relationships
3
Evidence topics
contributes_evidence
Editorial context
Why this study matters
See why this paper is useful beyond its individual results.
Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
Moderate contributionModerate confidenceNetwork score: 72
3
Related topics
8
Evidence pairs
98
Related studies
High relevance in at least one topic
Why it is useful
- Contributes to 8 evidence relationships
- Includes primary outcome data
- Linked to 3 direct semantic evidence topics
Topic contributions
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Evidencia principal
Relación de evidencia
GLP-1 Receptor Agonists and Cardiovascular Outcomes
Evidencia relacionada
Tema de evidencia
Cardiovascular Risk
Seguir evidencia
Tema de evidencia
GLP-1 Receptor Agonists
Seguir evidencia
Core evidence
Study findings
The primary outcomes reported in this study.
Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Liraglutide → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Liraglutide → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Evidence Intelligence™
- ImpactScore™
- 100
- Very Positive
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerIncidence of myocardial infarction
Liraglutide → Incidence of myocardial infarction
Liraglutide → Incidence of myocardial infarction
Evidence Intelligence™
- ImpactScore™
- 100
- Very Positive
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- ImpactScore™
- 25
- Negative
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- ImpactScore™
- 33
- Slightly Negative
- EvidenceScore™
- Strong
- Score 79 · Based on 3 studies
- ConsistencyScore™
- 67
- generally_consistent
Supporting studies: Based on 3 studies
Add to Evidence TrackerComposite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Semaglutide → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Semaglutide → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Evidence Intelligence™
- ImpactScore™
- 86
- Very Positive
- EvidenceScore™
- 86
- Strong
- ConsistencyScore™
- 71
- generally_consistent
Supporting studies: Based on 7 studies
Add to Evidence TrackerIncidence of myocardial infarction
Semaglutide → Incidence of myocardial infarction
Semaglutide → Incidence of myocardial infarction
Evidence Intelligence™
- ImpactScore™
- 100
- Very Positive
- EvidenceScore™
- Moderate
- Score 69 · Based on 2 studies
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 2 studies
Add to Evidence TrackerEvidence Intelligence™
- ImpactScore™
- 38
- Slightly Negative
- EvidenceScore™
- Strong
- Score 79 · Based on 4 studies
- ConsistencyScore™
- 35
- mixed
Supporting studies: Based on 4 studies
Add to Evidence TrackerBuild your personal Evidence Workspace
Create a free account to save studies and evidence pages, organize your personal Evidence Tracker, and keep the research you care about in one place.
Today's Activity
Your Evidence Workspace
Saved this study
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Evidence Tracker
12 tracked topics
Saved Studies
48 studies
Research Notes
Coming Soon
Weekly Evidence Digest
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La Evidencia Sugiere
- Liraglutide reduced the risk of nonfatal stroke and myocardial infarction, with a cumulative hazard decrease of -0.0177.
- Semaglutide also significantly reduced the risk of nonfatal stroke and myocardial infarction, with a cumulative hazard decrease of -0.1035.
- HbA1c levels mediated a significant portion of the cardiovascular benefits for both medications.
A quién se aplica
- Adults with type 2 diabetes.
- Patients at risk for cardiovascular events.
Tener en Cuenta
- The study's findings may not be applicable to all diabetes populations.
- Further research is needed to confirm long-term benefits and safety.
- The specific mechanisms by which HbA1c mediates these effects require further exploration.
Entre Líneas
- The effectiveness of the interventions remains unclear due to unspecified p-values.
- Potential limitations in generalizability due to the specific population studied.
- Lack of detailed information on long-term outcomes beyond the study duration.
Save this study
Keep this study in your Evidence Tracker so you can easily find it again whenever you need it.
Today's Activity
Your Evidence Workspace
Saved this study
Your free account becomes your personal diabetes evidence workspace.
Evidence Tracker
12 tracked topics
Saved Studies
48 studies
Research Notes
Coming Soon
Weekly Evidence Digest
Coming Soon
Already have an account?
Connected Evidence
Explore related studies, evidence collections, and research questions.
Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on GLP-1 Receptor Agonists and Cardiovascular Outcomes, GLP-1 Receptor Agonists and Nonfatal stroke.
Relaciones de evidencia relacionadas
Explore in Evidence ArchiveThis study contributes to the evidence on the following intervention-outcome relationships.
Medications
Detailed evidenceEvidence Intelligence™
- ImpactScore™
- 86
- Very Positive
- EvidenceScore™
- 86
- Strong
- ConsistencyScore™
- 71
- generally_consistent
Supporting studies: Based on 7 studies
View evidenceMedications
Detailed evidenceGLP-1 Receptor Agonists → Nonfatal stroke
Medications
Evidence Intelligence™
- ImpactScore™
- 38
- Slightly Negative
- EvidenceScore™
- Strong
- Score 79 · Based on 4 studies
- ConsistencyScore™
- 35
- mixed
Supporting studies: Based on 4 studies
View evidenceIncluido en estas colecciones de evidencia
Curated evidence collections and hubs this study is part of.
Cardiovascular Outcomes Evidence Hub
All studies measuring Cardiovascular Outcomes
7 studies
outcome_hubMeasures Cardiovascular Outcomes as a key outcome.
GLP-1 Receptor Agonists Evidence Hub
All studies on GLP-1 Receptor Agonists
7 studies
intervention_hubContributes to GLP-1 Receptor Agonists evidence base.
Nonfatal stroke Evidence Hub
All studies measuring Nonfatal stroke
4 studies
outcome_hubMeasures Nonfatal stroke as a key outcome.
Recent Diabetes Research
Latest published studies
recency_collection
Published within the last 2 years.
Explora más en el archivo de evidencia
Jump to pre-filtered views in the evidence archive.
All studies on Semaglutide and Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Intervention: SemaglutideOutcome: Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
7 results
All studies on Semaglutide and Nonfatal stroke
Intervention: SemaglutideOutcome: Nonfatal stroke
4 results
All studies on Semaglutide
Intervention: Semaglutide
7 results
All studies measuring Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Outcome: Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
7 results
All studies measuring Nonfatal stroke
Outcome: Nonfatal stroke
4 results
Questions answered by this study
Generated from the study's connected evidence using Evidence Intelligence™.
Does GLP-1 Receptor Agonists improve cardiovascular outcomes?
Strong Evidence
GLP-1 Receptor Agonists may improve Cardiovascular Outcomes.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
EvidenceScore™ Strong | EvidenceScore™ 85.5 | strong positive | ConsistencyScore™ Generally Consistent | 1 study
Why this answer: This answer is based on 11 supporting studies with consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Does Semaglutide improve cardiovascular death?
Strong Evidence
Semaglutide may worsen Cardiovascular death or be associated with harm.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
- 1
Cardiovascular death
EvidenceScore™ Strong | EvidenceScore™ 79.0 | weak negative | ConsistencyScore™ Generally Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
- Only one supporting study is available.
- Population details are unavailable.
Does Semaglutide improve nonfatal stroke?
Strong Evidence
Semaglutide may worsen Nonfatal stroke or be associated with harm.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Evidence caveat: The available evidence reports mixed findings.
Ranked evidence signals
- 1
Nonfatal stroke
EvidenceScore™ Strong | EvidenceScore™ 79.0 | weak negative | ConsistencyScore™ Mixed | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
- Only one supporting study is available.
- Population details are unavailable.
Does Semaglutide improve incidence of myocardial infarction?
Moderate Evidence
Semaglutide appears to improve Incidence of myocardial infarction.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
Incidence of myocardial infarction
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
- Only one supporting study is available.
- Population details are unavailable.
Next steps
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Evidence topics
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Related research
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Liraglutide is well tolerated in diabetes patients undergoing hemodialysis.Liraglutide may reduce stroke recurrence in type 2 diabetes patientsSemaglutide may reduce cardiovascular events in non-diabetic patients.Oral semaglutide reduces cardiovascular events in type 2 diabetesHigher semaglutide doses improve glucose control in type 2 diabetes
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