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

IF 10.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Heart failure Pub Date : 2025-05-01 DOI:10.1016/j.jchf.2024.12.004

Patric Karlström MD, PhD , Aldina Pivodic PhD , Michael Fu MD, PhD

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引用次数: 0

Abstract

Background

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.

Objectives

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

Methods

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.

Results

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%.

Conclusions

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.

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胰高血糖素样肽1受体激动剂与超重心力衰竭患者生存率提高相关

背景：胰高血糖素样肽1受体激动剂（GLP-1RAs）在保留射血分数和肥胖的心力衰竭（HF）患者中显示出改善的症状缓解和功能能力。目的：本研究的目的是评估GLP-1RA对心衰患者预后的影响。方法：回顾性分析自2007年以来瑞典HF登记处对体重指数（BMI）为bbb25 kg/m2的患者进行的回顾性分析，以评估GLP-1RA治疗是否与HF患者死亡率降低相关。结果：在整个队列中，34,247例患者未接受GLP-1RA治疗，808例患者接受了GLP-1RA治疗。在接受GLP-1RA治疗的患者中，96.3%患有糖尿病。GLP-1RA治疗与全因减少有统计学意义(校正HR [aHR]: 0.75 [95% CI: 0.60-0.94]；P = 0.013)和心血管（CV）死亡率(aHR: 0.52 [95% CI: 0.35-0.77]；P = 0.0010)，与指标登记后2年内未接受GLP-1RA的患者相比。在1:1倾向评分匹配的队列中，GLP-1RA与全因死亡率之间无显著关联(aHR: 0.79 [95% CI: 0.59-1.06]；P = 0.11)，但有CV死亡率(aHR: 0.53 [95% CI: 0.32-0.87]；P = 0.012)。在BMI为bbb30 kg/m2的患者中，glp - 1ra相关的CV死亡风险降低更为明显，并且在射血分数≤40%的患者中，与bbb40 %的患者相比，glp - 1ra相关的风险降低更大。结论：这项全国范围的真实世界研究表明，接受GLP-1RA治疗的HF患者心血管死亡率显著降低，这在射血分数降低的超重和肥胖患者中尤为明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Heart failure CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

21.20

自引率

2.30%

发文量

164

期刊介绍： JACC: Heart Failure publishes crucial findings on the pathophysiology, diagnosis, treatment, and care of heart failure patients. The goal is to enhance understanding through timely scientific communication on disease, clinical trials, outcomes, and therapeutic advances. The Journal fosters interdisciplinary connections with neuroscience, pulmonary medicine, nephrology, electrophysiology, and surgery related to heart failure. It also covers articles on pharmacogenetics, biomarkers, and metabolomics.