Researchers assessed the cardiovascular as well as renal outcomes with glucagon-like peptide-1 receptor agonists (GLP-1RAs) and links between these outcomes and HbA1c or weight reduction. They found that decrease in HbA1c, but not body weight, was linked with cardiovascular and renal outcomes, and that the magnitude of HbA1c decrease can serve as a surrogate for cardiovascular and renal benefits of GLP-1RAs.

• Randomized, placebo-controlled trials of GLP1-RAs documenting major adverse cardiovascular events (MACE; a composite of cardiovascular mortality, stroke, and myocardial infarction) as the primary outcome were identified.

• Meta‐analysis and meta‐regression analysis were conducted using data of 60,800 persons from eight eligible studies (ELIXA, LEADER, SUSTAIN-6, EXSCEL, HARMONY, PIONEER 6, REWIND, and AMPLITUDE-O).

• Treatment with GLP-1RAs resulted in reduction of MACE (hazard ratio [HR] 0.86) and secondary outcomes including the composite renal outcome (0.80).

• According to results of meta-regression analysis, every 1% decrease in HbA1c was shown to be related to 26% and 35% reductions in the logarithm of HR of MACE and the composite renal outcome, respectively.

• On the contrary, weight decrease was not linked with any outcome, including MACE.