The Expanding Cardiovascular and Cardiorenal Role of GLP-1 Receptor Agonists

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) provide cardiometabolic benefits that extend beyond glucose lowering.This Scoping Review systematically mapped cardiovascular and cardiorenal outcomes associated with GLP-1 RA therapy.The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.PubMed (MEDLINE) was searched from January 1, 2008 through February 1, 2026 using controlled vocabulary and free-text terms for GLP-1 RAs and cardiovascular and cardiorenal outcomes.Eligible studies included randomized controlled cardiovascular-outcome trials (CVOTs), meta-analyses, and large observational cohorts reporting major adverse cardiovascular events (MACE), cardiovascular death, heart-failure hospitalization, or renal composite endpoints.Seventeen studies met the inclusion criteria: ten randomized CVOTs, five meta-analyses, and two observational cohorts.Significant MACE reductions were observed with liraglutide (LEADER), semaglutide (SUSTAIN-6 and SOUL), dulaglutide (REWIND), albiglutide (HARMONY Outcomes), efpeglenatide (AMPLITUDE-O), and oral semaglutide (PIONEER-6), whereas lixisenatide (ELIXA) and exenatide (EXSCEL) were cardiovascularly neutral.The SELECT trial demonstrated a 20% MACE reduction in overweight or obese adults without diabetes.Meta-analyses confirmed class-wide reductions in MACE, cardiovascular death, and renal composite outcomes, and real-world data reproduced these associations across diverse clinical populations.Collectively, the totality of evidence supports GLP-1 RAs as diseasemodifying cardiometabolic therapies with broad applicability in cardiovascular prevention.