Impact of Heart Failure History at Baseline on Cardiovascular Effects of GLP-1 Receptor Agonists in Type 2 Diabetes: a Meta-analysis

Epicardial Fat Paradox and Differential Effects of GLP-1 Receptor Agonists Across Heart Failure Phenotypes

“…2,3 However, one recent meta-analysis found that GLP-1RA versus placebo reduced hospitalization for HF/cardiovascular death in only type 2 diabetes without HF history, but these effects were neutral in relatively stable patients with HF (P interaction <0.1). 4 While recent evidence points toward the benefits of GLP-1RA in obese people with HF with preserved ejection fraction (HFpEF), 5 a metaanalysis involving the participants of the EXSCEL trial (Exenatide Study of Cardiovascular Event Lowering) and the FIGHT trial (Functional Impact of GLP-1 for Heart Failure Treatment) showed an increased risk of hospitalization for HF in HF with reduced ejection fraction (HFrEF) with exenatide and liraglutide. 6 The risk of hospitalization for HF/death was limited to patients with New York Heart Association functional class III/ IV HF in the FIGHT trial.…”

“…14 Together, these may form the basis of GLP-1RAs' benefits in inflammatory HFpEF and pre-HF phenotypes. 4,5…”