Glucagon-like peptide-1 receptor agonists in patients with anthracycline related cardiac dysfunction

Cancer therapy-related cardiac dysfunction (CTRCD) is recognized complication of antineoplastic therapies, and is particularly associated with anthracyclines. Treatment revolves around heart failure management, with limited evidence for other medications. Specifically, the aim of this study is to evaluate the role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with CTRCD.

All adult cancer patients with a diagnosis of anthracycline induced CTRCD between 2012 and 2022 were retrieved from the TriNetX Research Network. Baseline characteristics, oncology data, and laboratory parameters were also abstracted. Patients were grouped based on administration of GLP-1RAs, with the development of a propensity matched non-GLP-1RA treatment cohort. Clinical outcomes were compared between the cohorts including all-cause mortality, all cause hospitalizations, acute heart failure events, acute renal failure, new atrial fibrillation, and cardiac arrest.

Overall, 2282 cancer patients with CTRCD were identified. Following propensity matching, a control cohort of 201 patients who did not receive GLP-1RAs were compared to 201 patients receiving GLP-1RAs. Over a mean follow-up of 295.4 ± 109.6 days, patients receiving GLP-1RAs treatment had significantly lower risk of all-cause hospitalization (HR 0.617, 95% CI 0.474-0.803, p < 0.001), acute heart failure events (HR 0.612, 95% CI 0.428-0.875, p = 0.007), and acute renal failure (HR 0.577, 95% CI 0.408-0.815, p = 0.002). There were no significant differences in the risk of all-cause mortality, atrial fibrillation, or cardiac arrest.

In cancer patients with anthracycline induced CTRCD, those treated with GLP-1RAs had significantly lower risk of adverse clinical outcomes.