Role of GLP-1 Receptor Agonists in Managing Cancer Therapy-Related Cardiac Dysfunction

Current anticancer treatments can result in cancer therapy-related cardiac dysfunction (CTRCD). While glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated cardioprotective properties, their role in CTRCD has not been previously explored.

This retrospective cohort study utilized the TriNetX research network. Adults aged ≥18 years who had a cancer history and who underwent antineoplastic therapy and developed CTRCD between January 1, 2012 and January 1, 2023 were included. Among patients on guideline-directed medical therapy for heart failure, 2 groups were identified: GLP-1 RA users and nonusers. Propensity score matching (1:1) was conducted based on demographics, comorbid conditions, and concurrent medications, yielding a matched sample of 837 patients. Outcomes were assessed over a 1-year follow-up period.

The study cohort found 4982 patients with CTRCD; 837 received GLP-1 RA therapy (mean age: 69.0 years; 43.8% female; 70.4% White). Compared with nonusers, those treated with GLP-1 RAs alongside guideline-directed medical therapy had significantly lower rates of all-cause mortality (hazard ratio, 0.57 [95% CI, 0.43-0.77]; P<0.001), acute heart failure exacerbations (hazard ratio, 0.69 [95% CI, 0.56-0.85]; P<0.001), and all-cause hospitalizations (hazard ratio, 0.83 [95% CI, 0.72-0.96]; P=0.009). While reductions in atrial fibrillation/flutter and ventricular tachycardia were observed, they were not statistically significant.

Among patients with CTRCD receiving guideline-directed medical therapy, GLP-1 RA use may be linked to better 1-year survival and improved heart failure-related outcomes.