Efficacy of GLP-1 Receptor Agonists in Patients With Heart Failure and Mildly Reduced or Preserved Ejection Fraction: A Systematic Review and Meta-Analysis
JOURNAL OF CARDIAC FAILURE, vol.31, no.7, pp.1076-1080, 2025 (SCI-Expanded, Scopus)
- Publication Type: Article / Review
- Volume: 31 Issue: 7
- Publication Date: 2025
- Doi Number: 10.1016/j.cardfail.2025.01.022
- Journal Name: JOURNAL OF CARDIAC FAILURE
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Page Numbers: pp.1076-1080
- Azerbaijan State University of Economics (UNEC) Affiliated: No
Abstract
Background: Heart failure (HF) with mildly reduced or preserved ejection fraction (HFpEF) accounts for over half of cases of HF, with obesity playing a key role. Residual risk remains high despite available therapies. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown potential cardiometabolic benefits, but their role in HFpEF remains unclear. Methods: A systematic review and meta-analysis of randomized controlled trials evaluating GLP-1RAs in HFpEF were conducted. Studies evaluating GLP-1RA in combination with glucose-dependent insulinotropic polypeptide (GIP) were also included. The analyzed outcomes included cardiovascular (CV) death, worsening HF events and their composite. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled by using a random-effects model. Results: Six randomized controlled trials involving 8788 patients were included. GLP-1RAs significantly reduced the composite outcome of CV death or worsening HF events (HR: 0.68 [0.51-0.89]; P = 0.006, I2 = 47%) as well as worsening HF events alone (HR: 0.56 [0.38-0.82]; P = 0.003, I2 = 51%). No significant reduction was observed for CV death alone (HR: 0.86 [0.67-1.12]; P = 0.27, I2 = 0%). Conclusion: GLP-1RAs reduce worsening HF events and the composite of CV death or worsening HF in HFpEF, particularly in patients with obesity or diabetes. These findings support their role as a promising therapy requiring further HFpEF-focused trials. (J Cardiac Fail 2025;31:1076-1080)