Glucagon-Like Peptide 1 Receptor Agonist Is Associated With Improved Survival in Overweight Heart Failure Patients

Glucagon-like peptide 1 receptor agonists (GLP-1RAs) have shown improved symptomatic relieving and functional capacity in patients with heart failure (HF) with preserved ejection fraction and obesity.

The purpose of this study was to evaluate the effect of GLP-1RA on outcome in patients with HF.

A retrospective analysis was performed based on the Swedish HF Registry since 2007 among patients with a body mass index (BMI) >25 kg/m² to assess whether GLP-1RA treatment was associated with reduced mortality in patients with HF.

In the overall cohort, 34,247 patients were not treated with GLP-1RA, and 808 patients were. In patients treated with GLP-1RA, 96.3% had diabetes mellitus. Treatment with GLP-1RA showed a statistically significant association with reduced all-cause (adjusted HR [aHR]: 0.75 [95% CI: 0.60-0.94]; P = 0.013) and cardiovascular (CV) mortality (aHR: 0.52 [95% CI: 0.35-0.77]; P = 0.0010) compared with those not receiving GLP-1RA within 2 years after index registration. In a 1:1 propensity score matched cohort, there was no significant association between GLP-1RA and all-cause mortality (aHR: 0.79 [95% CI: 0.59-1.06]; P = 0.11), but there was with CV mortality (aHR: 0.53 [95% CI: 0.32-0.87]; P = 0.012). GLP-1RA-associated risk reduction in CV death was more pronounced in patients with a BMI >30 kg/m² and appears to be greater in individuals with an ejection fraction ≤40% compared with >40%.

This nationwide real-world study shows that patients with HF who received GLP-1RA have a significant reduction in CV mortality, which is particularly pronounced in overweight and obese patients with reduced ejection fraction.