The potential of glucagon-like peptide-1 receptor agonists in heart failure

Frederik Flindt Kreiner1, G Kees Kornelis Hovingh1,2, Bernt Johan von Scholten1

  • 1Global Chief Medical Office, Novo Nordisk A/S, Søborg, Denmark.

Frontiers in Physiology
|October 7, 2022
PubMed

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show promise in reducing heart failure (HF) hospitalizations. These drugs may offer cardioprotective benefits by managing diabetes, obesity, and inflammation.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Heart failure (HF) presents a significant unmet medical need with high morbidity and mortality.
  • HF is closely linked with cardiometabolic diseases like diabetes, obesity, and chronic kidney disease.
  • Integrated strategies addressing these intertwined conditions are highly desirable.

Purpose of the Study:

  • To review the emerging evidence for the cardioprotective effects of GLP-1 RAs in HF.
  • To explore the potential of GLP-1 RAs as a therapeutic strategy for HF patients.
  • To identify the most relevant HF phenotypes for GLP-1 RA treatment.

Main Methods:

  • Analysis of data from large cardiovascular outcomes trials (CVOTs) of GLP-1 RAs.
  • Review of meta-analyses examining GLP-1 RA efficacy in HF.
  • Examination of mechanistic studies investigating GLP-1 RA effects on cardiovascular health.

Main Results:

  • CVOTs indicate a significant relative risk reduction in HF hospitalizations with GLP-1 RAs.
  • A meta-analysis of eight GLP-1 RA CVOTs showed an 11% relative risk reduction for HF hospitalization.
  • Mechanistic insights suggest indirect cardioprotective benefits through improved glycemic control, weight reduction, and reduced inflammation.

Conclusions:

  • GLP-1 RAs demonstrate potential as a cardioprotective strategy in heart failure.
  • HF with preserved ejection fraction in patients with obesity (with or without diabetes) appears to be the most relevant phenotype for GLP-1 RA therapy.
  • Further research is warranted to fully elucidate the role of GLP-1 RAs in HF management.

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