Effect of semaglutide on arrhythmic, major cardiovascular, and renal outcomes in patients with overweight or obesity: a systematic review and meta-analysis.

Wu R, Xing B, Zhou Z, Yu L, Wang H

European journal of medical research2 Sept 2025Cited by 3 (Europe PMC)

PMID40890879PMCIDPMC12403603DOI10.1186/s40001-025-03124-yPepBankPUB-40890879

Summary

BackgroundSemaglutide has demonstrated potential in controlling hyperglycemia and lowering cardiovascular (CV) risk. However, its impact on arrhythmic, major CV, and renal outcomes is not well-defined. This systematic review and meta-analysis aimed to assess these effects in patients with overweight or obesity.MethodsWe searched the PubMed, Embase, and Cochrane databases for eligible randomized controlled trials (RCTs) reported up to January 2025. We calculated overall relative risks (RRs) with 95% confidence intervals (CIs) for these outcomes. In addition, subgroup analyses were performed based on age, treatment duration and obesity level.ResultsTen RCTs involving 22,937 patients were included. Compared with the controls, semaglutide significantly reduced the risk of atrial fibrillation (AF) (RR 0.79, 95% CI 0.63-0.99), sinus node dysfunction (RR 0.43, 95% CI 0.19-1.00), acute myocardial infarction (RR 0.72, 95% CI 0.60-0.85), and angina pectoris (RR 0.77, 95% CI 0.61-0.98). Subgroup analyses revealed greater efficacy in patients over 60 years old and those treated for more than 52 weeks, especially for acute myocardial infarction, angina pectoris, and acute kidney injury.ConclusionSemaglutide reduces the risk of AF, sinus node dysfunction, acute myocardial infarction, and angina pectoris in patients with overweight or obesity. However, its effects on other arrhythmic, CV, and renal outcomes remain uncertain.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study5

5 results from studies that gave the peptide. 5 results from people.

01HumanSystematic reviewEfficacy outcome
In patients with overweight or obesity, pooled RCTs showed semaglutide reduced the risk of atrial fibrillation versus controls (RR 0.79).
In plain wordsIn people with overweight or obesity, pooled trials found semaglutide lowered the risk of atrial fibrillation compared with controls.
Peptide
Semaglutide
Outcome
DecreaseAtrial fibrillation
Study
n = 22,937
Comparator
Controls
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Measurements
RR
0.79 ratio
atrial fibrillation
Source sentences
Summary
Compared with the controls, semaglutide significantly reduced the risk of atrial fibrillation (AF) (RR 0.79, 95% CI 0.63-0.99), sinus node dysfunction (RR 0.43, 95% CI 0.19-1.00), acute myocardial infarction (RR 0.72, 95% CI 0.60-0.85), and angina pectoris (RR 0.77, 95% CI 0.61-0.98).
2 context sentences(design, population, supporting numbers)
Title · context
Effect of semaglutide on arrhythmic, major cardiovascular, and renal outcomes in patients with overweight or obesity: a systematic review and meta-analysis.
Summary · context
Ten RCTs involving 22,937 patients were included.
Show in the study text Report a problemFND-4089087901
02HumanSystematic reviewEfficacy outcome
In patients with overweight or obesity, pooled RCTs showed semaglutide reduced the risk of sinus node dysfunction versus controls (RR 0.43, 95% CI 0.19-1.00).
In plain wordsIn people with overweight or obesity, pooled trials found semaglutide lowered the risk of sinus node dysfunction compared with controls.
Peptide
Semaglutide
Outcome
DecreaseSinus node dysfunction
Study
n = 22,937
Comparator
Controls
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Measurements
RR
0.43 ratio
sinus node dysfunction
Source sentences
Summary
Compared with the controls, semaglutide significantly reduced the risk of atrial fibrillation (AF) (RR 0.79, 95% CI 0.63-0.99), sinus node dysfunction (RR 0.43, 95% CI 0.19-1.00), acute myocardial infarction (RR 0.72, 95% CI 0.60-0.85), and angina pectoris (RR 0.77, 95% CI 0.61-0.98).
2 context sentences(design, population, supporting numbers)
Title · context
Effect of semaglutide on arrhythmic, major cardiovascular, and renal outcomes in patients with overweight or obesity: a systematic review and meta-analysis.
Summary · context
Ten RCTs involving 22,937 patients were included.
Show in the study text Report a problemFND-4089087902
03HumanSystematic reviewEfficacy outcome
In patients with overweight or obesity, pooled RCTs showed semaglutide reduced the risk of acute myocardial infarction versus controls (RR 0.72).
In plain wordsIn people with overweight or obesity, pooled trials found semaglutide lowered the risk of heart attack compared with controls.
Peptide
Semaglutide
Outcome
DecreaseAcute myocardial infarction
Study
n = 22,937
Comparator
Controls
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Measurements
RR
0.72 ratio
acute myocardial infarction
Source sentences
Summary
Compared with the controls, semaglutide significantly reduced the risk of atrial fibrillation (AF) (RR 0.79, 95% CI 0.63-0.99), sinus node dysfunction (RR 0.43, 95% CI 0.19-1.00), acute myocardial infarction (RR 0.72, 95% CI 0.60-0.85), and angina pectoris (RR 0.77, 95% CI 0.61-0.98).
2 context sentences(design, population, supporting numbers)
Title · context
Effect of semaglutide on arrhythmic, major cardiovascular, and renal outcomes in patients with overweight or obesity: a systematic review and meta-analysis.
Summary · context
Ten RCTs involving 22,937 patients were included.
Show in the study text Report a problemFND-4089087903
04HumanSystematic reviewEfficacy outcome
In patients with overweight or obesity, pooled RCTs showed semaglutide reduced the risk of angina pectoris versus controls (RR 0.77).
In plain wordsIn people with overweight or obesity, pooled trials found semaglutide lowered the risk of angina compared with controls.
Peptide
Semaglutide
Outcome
DecreaseAngina pectoris
Study
n = 22,937
Comparator
Controls
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Measurements
RR
0.77 ratio
angina pectoris
Source sentences
Summary
Compared with the controls, semaglutide significantly reduced the risk of atrial fibrillation (AF) (RR 0.79, 95% CI 0.63-0.99), sinus node dysfunction (RR 0.43, 95% CI 0.19-1.00), acute myocardial infarction (RR 0.72, 95% CI 0.60-0.85), and angina pectoris (RR 0.77, 95% CI 0.61-0.98).
2 context sentences(design, population, supporting numbers)
Title · context
Effect of semaglutide on arrhythmic, major cardiovascular, and renal outcomes in patients with overweight or obesity: a systematic review and meta-analysis.
Summary · context
Ten RCTs involving 22,937 patients were included.
Show in the study text Report a problemFND-4089087904
05HumanSystematic reviewEfficacy outcome
In patients with overweight or obesity, semaglutide efficacy was greater in patients over 60 years and with treatment for more than 52 weeks, especially for acute myocardial infarction, angina pectoris and acute kidney injury.
In plain wordsIn people with overweight or obesity, semaglutide worked better in people over 60 and with treatment longer than 52 weeks in pooled trials.
Peptide
Semaglutide
Outcome
DecreaseSubgroup effect by age and treatment duration
Study
n: not reported in source
Comparator
Controls
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Source sentences
Summary
Subgroup analyses revealed greater efficacy in patients over 60 years old and those treated for more than 52 weeks, especially for acute myocardial infarction, angina pectoris, and acute kidney injury.
2 context sentences(design, population, supporting numbers)
Title · context
Effect of semaglutide on arrhythmic, major cardiovascular, and renal outcomes in patients with overweight or obesity: a systematic review and meta-analysis.
Summary · context
Ten RCTs involving 22,937 patients were included.
Show in the study text Report a problemFND-4089087905

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

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Version 2Current
11 Oct 2026, 00:04 UTC
Study results updated
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC

Subjects

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Effect of semaglutide on arrhythmic, major cardiovascular, and renal outcomes in patients with overweight or obesity: a systematic review and meta-analysis.

Summary

Results from this study5

Version history

Subjects

Publication types

MeSH terms

Keywords