This meta-analysis pooled eight randomised placebo-controlled trials of GLP-1 receptor agonists in 71,926 adults with type 2 diabetes or overweight/obesity. It tested whether effects on major adverse cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, non-fatal stroke) differ by age. Age-stratified hazard ratios were combined with random-effects models, and ratios of hazard ratios tested effect modification. Pooled hazard ratios were 0.81 (95% CI 0.69-0.94) under 65 and 0.84 (0.79-0.90) at 65 and over. The ratio of hazard ratios was 1.03 (0.85-1.25), with high between-trial heterogeneity (I2 59.3%). Only four trials reported a 75-and-over stratum, and that group was relatively small.
Why it is interesting: It tests whether the trial reduction in cardiovascular deaths, heart attacks and strokes holds at older ages. Relative effects looked similar across age bands, though evidence above 75 rests on four trials and a small group.
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