TOPLINE:

In patients with heart failure with reduced ejection fraction (HFrEF), the use of GLP-1 receptor agonists (RAs) was associated with reduced all-cause mortality and fewer hospitalizations due to acute decompensated heart failure (ADHF), with no increased risk for atrial or ventricular arrhythmias.

METHODOLOGY:

• Researchers conducted a retrospective study using electronic health records from a large database covering 72 predominantly US healthcare organizations to evaluate the efficacy and safety of GLP-1 RAs in adults with HFrEF (left ventricular ejection fraction ≤ 40% on transthoracic echocardiography).
• They included 2550 propensity-matched patients and categorized them into those who were prescribed a GLP-1 RA (n = 1275; mean age, 61.5 years; 33.1% female) and those who were not (n = 1275; mean age, 61.5 years; 35% female).
• GLP-1 RA users received liraglutide, semaglutide, or tirzepatide within 3 months before or after the transthoracic echocardiography. Patients were followed for up to 1 year.
• Primary outcomes were all-cause mortality and ADHF exacerbations leading to inpatient admissions. Secondary outcomes were new-onset acute coronary syndrome (ACS), stroke or transient ischemic attack (TIA), atrial fibrillation or flutter, and ventricular tachycardia or fibrillation events.

TAKEAWAY:

• At 1 year, GLP-1 RA users had a 32% lower risk for all-cause mortality (odds ratio [OR], 0.68; P = .006) and a 21% lower risk for ADHF hospitalizations (OR, 0.79; P = .005) than nonusers.
• Events of new-onset ACS, stroke or TIA, atrial fibrillation or flutter, and ventricular tachycardia or fibrillation events were not significantly different between groups.

IN PRACTICE:

“We found that GLP-1 RA use in patients with HFrEF was associated with lower risks of all-cause mortality and ADHF without an apparent increase in arrhythmic events,” the authors of the study wrote. “These results should be interpreted with caution and considered hypothesis-generating rather than practice-changing,” they added.

SOURCE:

The study was led by Joseph Kassab, MD, UT Southwestern Medical Center, Dallas. It was published online on April 17 in ESC Heart Failure.

LIMITATIONS:

Reliance on data from an aggregated electronic health record database may have limited the accuracy of reported health conditions and completeness of captured outcomes. Also, cardiovascular-specific mortality was not assessed, and the 1-year follow-up duration might have been inadequate to study long-term outcomes.

DISCLOSURES:

The study received no financial support. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.