medwireNews: A meta-analysis suggests that glucagon-like peptide (GLP)-1 receptor agonists may help prevent new-onset heart failure in people with type 2 diabetes.
However, in people with preexisting heart failure, GLP-1 receptor agonist treatment did not reduce the risk for acute heart failure events or mortality.
The meta-analysis, which is published in Diabetes, Obesity and Metabolism, included 54,092 participants of seven randomized controlled trials of GLP-1 receptor agonists in people with type 2 diabetes, 16% of whom had a history of heart failure.
Among those without preexisting heart failure, being assigned to GLP-1 receptor agonist treatment was associated with a significant 16% reduction in the risk for the composite outcome of heart failure hospitalization or cardiovascular death.
This was driven mainly by a 15% reduction in the risk for cardiovascular death, and there was also a 15% reduced risk for all-cause death. The risk for heart failure hospitalization was reduced by a nonsignificant 19%.
By contrast, none of these outcomes were influenced by treatment allocation in participants with a history of heart failure. However, GLP-1 receptor agonist treatment significantly reduced the risk for major adverse cardiovascular events regardless of whether the participants had heart failure, with 15% and 12% reductions in those with and without a history of heart failure, respectively.
But João Pedro Ferreira (University of Porto, Portugal) and co-researchers stress that the treatment benefits and risks of GLP-1 receptor agonists are less clear in people who have advanced heart failure, recent acute heart failure events, or a severely reduced ejection fraction – subgroups that were not included in the analyzed clinical trials.
Indeed, they point to smaller studies suggesting that GLP-1 receptor agonists may be associated with an increased risk for serious cardiac events, particularly arrhythmias, in this subgroup.
And the team stresses the demonstrated protective effects of sodium-glucose cotransporter 2 inhibitors against heart failure events irrespective of whether people have the condition at baseline.
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