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Effects of glucagon-like peptide-1 receptor agonists on patients with heart failure: a meta-analysis of randomized

Shota Obata1, Yoshihisa Miyamoto2, Leandro Slipczuk3

  • 1Department of Medicine, Mount Sinai Beth Israel, New York, New York, USA.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|December 30, 2022
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce major adverse cardiovascular events (MACE) in type 2 diabetes patients with heart failure. However, GLP-1RAs did not significantly alter heart failure admission rates in this population.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established to reduce cardiovascular events in type 2 diabetes mellitus (T2DM).
  • Subgroup analyses of prior trials suggest these benefits may not extend to patients with pre-existing heart failure.
  • This study specifically investigates GLP-1RA efficacy in T2DM patients with a history of heart failure.

Approach:

  • A systematic literature search of PubMed and EMBASE was conducted through March 2022.
  • Included randomized controlled trials (RCTs) comparing GLP-1RAs with placebo in T2DM patients with heart failure history.
  • A random-effects model meta-analysis was performed to assess major adverse cardiovascular events (MACE) and heart failure admissions.

Key Points:

  • The meta-analysis included 7 RCTs with 8,965 patients.
  • GLP-1RAs significantly reduced MACE (HR 0.88, P=0.039) in T2DM patients with prior heart failure.
  • No significant difference was observed in heart failure admission rates (HR 1.03, P=0.67).

Conclusions:

  • GLP-1RAs demonstrate a significant benefit in reducing MACE for T2DM patients who have a history of heart failure.
  • The risk of heart failure admissions was not significantly impacted by GLP-1RA treatment in this cohort.
  • Further research may be warranted to elucidate the mechanisms behind these differential effects.

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