A real-world propensity analysis of the impact of GLP-1 receptor agonists on cancer therapy-related cardiac dysfunction

Heart damage caused by cancer treatment can lead to heart failure, hospital admission, and death. Medications known as glucagon-like peptide-1 receptor agonists are widely used to treat type 2 diabetes with cardioprotective potentials. Whether these medications can reduce heart damage related to cancer therapy remains uncertain. This study aims to evaluate the association between glucagon-like peptide-1 receptor agonist use and the risk of heart damage in patients receiving cancer treatments. We conducted a retrospective cohort study using a large international real-world health records database from January 2017 to March 2025. Adult patients with cancer who received heart-damaging cancer therapies were included and grouped according to use of glucagon-like peptide-1 receptor agonists. Patients were carefully matched to ensure comparable baseline characteristics. Clinical outcomes over 12 months were analyzed using time-to-event statistical models, with additional subgroup and sensitivity analyses. Here we show that use of glucagon-like peptide-1 receptor agonists is associated with a significantly lower risk of cancer therapy-related heart damage, death from any cause, hospital admission, blocked blood vessels, blood clots, and overall cardiovascular complications. The protective effects are most pronounced in women, younger patients, individuals with excess body weight, and those with type 2 diabetes. Benefits are observed across different cancer treatments and are particularly evident with anthracycline chemotherapy. Glucagon-like peptide-1 receptor agonist use is associated with reduced heart damage during cancer treatment, suggesting a potential role for these medications in protecting cardiovascular health among cancer patients, especially those with type 2 diabetes. Chemotherapy drugs are a type of cancer treatment, but some chemotherapy drugs, especially anthracyclines, can cause damage to the heart (cardiotoxicicity). This condition, called cancer therapy-related cardiac dysfunction (CTRCD), can lead to heart failure, hospital admission, or death in people with cancer. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are medications used to treat type 2 diabetes and obesity and might protect the heart from damage. In this study, we compared people with cancer who did and did not receive GLP-1 RAs while being treated with heart-damaging cancer drugs. Patients in the two groups were carefully matched to ensure fair comparison. Among more than 8,000 comparable patient pairs, GLP-1 RA use was linked to lower risks of heart damage, death, hospital admission, blocked blood vessels, and blood clots. The benefits were strongest in women, younger patients, overweight individuals, and those with type 2 diabetes, particularly among patients treated with anthracyclines. These results suggest GLP-1 RA could be used to reduce side effects when taking chemotherapy. Wu et al. compare people with cancer receiving heart-damaging therapies with and without glucagon-like peptide-1 receptor agonist treatment. Use of these medications is associated with lower risks of treatment-related heart damage, mortality, hospitalization, and cardiovascular complications, particularly in patients with diabetes.