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Research Summary
Analyzed using Evidence Intelligence™

Semaglutide reduces cardiovascular risks in type 2 diabetes with CKD

Powered by the Dediabetes Evidence Intelligence™ framework

Key finding

Semaglutide reduced CV death/MI/stroke by 18% [hazard ratio (HR) 0.82 (95% confidence interval 0.68–0.98); P = .03]

The FLOW trial investigated the effects of semaglutide on cardiovascular outcomes in patients with type 2 diabetes and chronic kidney disease, revealing significant reductions in cardiovascular death, myocardial infarction, and stroke.

Evidence strength

Moderate confidence

Study type

RCTs

Follow-up

Long-Term (1–5 y)

Some Concerns bias
Last updated July 6, 2026

Quick read

Study at a glance

The essential study design details in one scan.

Population

Young Adult (19–39), Middle Aged (40-64), Male, Female, Asia-Pacific (APAC), with T2 Diabetes

Intervention

Semaglutide, Placebo

Study type

RCTs

Follow-up

Long-Term (1–5 y)

Primary outcome

Composite of CV death

Comparator

Placebo

Plain-language summary

What this paper says

A plain-language read of the study's main message and where it applies.

Study focus

The FLOW trial investigated the effects of semaglutide on cardiovascular outcomes in patients with type 2 diabetes and chronic kidney disease, revealing significant reductions in cardiovascular death, myocardial infarction, and stroke.

Clinical relevance

The findings from the FLOW trial are clinically significant as they highlight the potential of semaglutide to improve cardiovascular outcomes in a vulnerable population. Patients with type 2 diabetes and chronic kidney disease are at increased risk for cardiovascular events, and effective interventions like semaglutide could lead to better health outcomes and reduced mortality rates in this group.

Keep in mind

The study's effectiveness data were unclear for some outcomes. Results may not be generalizable to populations outside the trial. Potential unmeasured confounders may affect the outcomes. The trial design may limit long-term outcome assessments.

Published in

Journal Reference

Publication details and source links for this paper.

Kenneth WM, Katherine RT, Mustafa A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Chronic Kidney Disease: Results from the FLOW Trial. European Heart Journal. 2025;46(12):1096-1108. doi:10.1093/eurheartj/ehae613

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Main Effects

Semaglutide reduced the composite of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke by 18% (HR 0.82, p = 0.03).

All-cause mortality was reduced by 20% with semaglutide (HR 0.80, p = 0.01).

No significant difference was observed in the composite outcome between groups (p = 0.03).

No significant difference was found in all-cause mortality between groups (p = 0.01).

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Semaglutide and All-cause mortality, Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke.

This study contributes evidence to

Intervention

Semaglutide

Outcome

All-cause mortality

Evidence topic

Cardiovascular Risk

Primary intervention

Semaglutide

Primary outcomes

  • All-cause mortality
  • Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Evidence topics

Cardiovascular RiskGLP-1 Receptor Agonists

Primary intervention

Semaglutide

Primary outcomes

All-cause mortalityComposite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

2
Evidence pairs
2
Relationships
2
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: 60

2

Related topics

2

Evidence pairs

75

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 2 evidence relationships
  • Includes primary outcome data
  • Linked to 2 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Core evidence

Study findings

The primary outcomes reported in this study.

StrongDecrease

All-cause mortality

Semaglutide → All-cause mortality

Semaglutide → All-cause mortality

Evidence profile

StrongDecreaseClinical Outcomes
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StrongDecrease

Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Semaglutide → Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Semaglutide → Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Evidence profile

StrongDecreaseClinical Outcomes
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evidence suggest

Evidence Suggest

  • Semaglutide significantly reduced cardiovascular events by 18% (HR 0.82).
  • All-cause mortality was reduced by 20% (HR 0.80).
  • No significant differences were found for some outcomes.
who this applies

Who this applies to

  • Adults with type 2 diabetes.
  • Patients with chronic kidney disease.
  • Individuals at high risk for cardiovascular events.
keep in mind

Keep in Mind

  • Results are based on a specific population and may not apply to all patients.
  • The study's design may have limitations affecting the interpretation of results.
  • Further research is needed to confirm long-term benefits and safety.
between the lines

Between the Lines

  • The study's effectiveness data were unclear for some outcomes.
  • Results may not be generalizable to populations outside the trial.
  • Potential unmeasured confounders may affect the outcomes.
  • The trial design may limit long-term outcome assessments.

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

Powered by the Dediabetes Evidence Intelligence™ framework

This study contributes to evidence on GLP-1 Receptor Agonists and Cardiovascular Outcomes, GLP-1 Receptor Agonists and Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke.

Related evidence relationships

Explore in Evidence Archive

This study contributes to the evidence on the following intervention-outcome relationships.

Included in these evidence collections

Curated evidence collections and hubs this study is part of.

Cardiovascular Outcomes Evidence Hub

All studies measuring Cardiovascular Outcomes

6 studies
outcome_hub

Measures Cardiovascular Outcomes as a key outcome.

GLP-1 Receptor Agonists Evidence Hub

All studies on GLP-1 Receptor Agonists

6 studies
intervention_hub

Contributes to GLP-1 Receptor Agonists evidence base.

Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke Evidence Hub

All studies measuring Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

2 studies
outcome_hub

Measures Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke as a key outcome.

Recent Diabetes Research

Latest published studies

recency_collection

Published within the last 2 years.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does GLP-1 Receptor Agonists improve cardiovascular outcomes?

Emerging Evidence

GLP-1 Receptor Agonists may improve Cardiovascular Outcomes.

ConsensusScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    All-cause mortality

    EvidenceScore™ Emerging | EvidenceScore™ 54.4 | weak positive | ConsensusScore™ Mixed | 1 study

Why this answer: This answer is based on 9 supporting studies with generally consistent results and a positive effect signal.

Limitations

  • Population details are unavailable.
9 supporting studiesUpdated: Jul 2026
View Full Evidence

Does Semaglutide improve composite of cv death, non-fatal myocardial infarction, or non-fatal stroke?

Emerging Evidence

Semaglutide may improve Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke.

ConsensusScore™: Results are mixed and should be interpreted cautiously.

Evidence caveat: The available evidence reports mixed findings.

Ranked evidence signals

  1. 1

    Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

    EvidenceScore™ Emerging | EvidenceScore™ 47.8 | moderate positive | ConsensusScore™ 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.
1 supporting studyUpdated: Jul 2026
View Full Evidence
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Next steps

Continue your research

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Evidence topics

Follow the topics this study contributes to.

Cardiovascular Risk Evidence HubGLP-1 Receptor Agonists Evidence Hub

Explore in archive

Open broader archive views for this relationship.

All studies on Semaglutide and All-cause mortalityAll studies on Semaglutide and Composite of CV death, non-fatal myocardial infarction, or non-fatal stroke

Related research

Read related research summaries.

Semaglutide 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 diabetesNovel Semaglutide Injection Shows Non-Inferior Glycemic ControlOral semaglutide may improve cardiovascular event prevention in type 2 diabetes.

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