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Effects of GLP-1 Agonists on mortality and arrhythmias in patients with Type II diabetes

Mohammed A Al-Sadawi1, Faisal M Aslam1, Michael Tao1

  • 1Cardiovascular Department, Stony Brook Medicine, Stony Brook, NY, USA.

International Journal of Cardiology. Heart & Vasculature
|May 30, 2023
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce all-cause and cardiovascular mortality in type II diabetes patients. These agents do not increase the risk of atrial or ventricular arrhythmias and sudden cardiac death.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for type II diabetes management.
  • The cardiovascular effects of GLP-1 RAs remain incompletely understood.
  • Assessing GLP-1 RA impact on mortality and arrhythmias is crucial for patient care.

Purpose of the Study:

  • To evaluate the effect of GLP-1 RAs on mortality, including all-cause and cardiovascular causes.
  • To determine the association between GLP-1 RA use and the risk of atrial and ventricular arrhythmias.
  • To investigate the impact of GLP-1 RAs on sudden cardiac death incidence.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, CINAHL) up to May 2022.
  • Included randomized controlled trials (RCTs) comparing GLP-1 RAs (albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, semaglutide) with control groups.
  • Data from 44 RCTs involving 78,702 patients were analyzed for mortality and arrhythmia outcomes.

Main Results:

  • GLP-1 RA use was associated with a significantly lower risk of all-cause mortality (OR 0.891, P < 0.01).
  • A reduced risk of cardiovascular mortality was observed in patients treated with GLP-1 RAs (OR 0.88, P < 0.01).
  • No significant increase in the risk of atrial arrhythmias (OR 0.963, P = 0.46) or ventricular arrhythmias and sudden cardiac death (OR 0.895, P = 0.36) was found.

Conclusions:

  • GLP-1 receptor agonists demonstrate a favorable impact on mortality in type II diabetes.
  • These findings suggest GLP-1 RAs can be safely used without increasing the risk of major cardiac arrhythmias.
  • GLP-1 RAs represent a valuable therapeutic option for managing type II diabetes with potential cardiovascular benefits.
Keywords:
ArrhythmiasGLP-1 agonistsMortalityOutcomesSudden cardiac death

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