GLP-1 Receptor Agonists Among Patients With Overweight or Obesity, Diabetes, and HFpEF on SGLT2 Inhibitors (JACC Heart Failure November 2024)-Article: GLP-1 Receptor Agonists Among Patients With Overweight or Obesity, Diabetes, and HFpEF on SGLT2 Inhibitors

Article: GLP-1 Receptor Agonists Among Patients With Overweight or Obesity, Diabetes, and HFpEF on SGLT2 Inhibitors

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The study examined the effects of combining GLP-1 receptor agonists (GLP-1 RA) with SGLT2 inhibitors (SGLT2i) in patients with heart failure with preserved ejection fraction (HFpEF), diabetes, and overweight or obesity. It used a retrospective cohort design involving data from roughly 110 million patient records from U.S. healthcare institutions. Participants were divided into two groups: those receiving both GLP-1 RA and SGLT2i, and those on SGLT2i alone. Over a 12-month follow-up period, the study evaluated outcomes like heart failure exacerbations and hospital admissions.<br /><br />The results showed that adding GLP-1 RA to SGLT2i significantly lowered the risk of heart failure exacerbations, atrial arrhythmias, acute kidney injury, pulmonary hypertension, and all-cause emergency visits or hospitalizations compared to using SGLT2i alone. Although the combined therapy increased the risk of diabetic retinopathy, there were no higher risks for other adverse effects. <br /><br />Subgroup analyses indicated these benefits persisted across different body mass index (BMI) categories and left ventricular ejection fraction levels. The study suggests the combined therapy offers additional cardiometabolic benefits, hinting at its potential to improve overall patient outcomes compared to SGLT2i treatment alone.<br /><br />The research highlights a new therapeutic option for patients with HFpEF and associated conditions, though prospective studies are needed to confirm these findings and explore the mechanisms behind the added benefits of the combination therapy. Despite potential biases inherent in a retrospective study, the significant number of participants strengthens the argument for further clinical trials to substantiate these preliminary results.

Keywords

GLP-1 receptor agonists

SGLT2 inhibitors

heart failure

preserved ejection fraction

diabetes

obesity

retrospective cohort

cardiometabolic benefits

diabetic retinopathy

clinical trials