Does glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce incident atrial fibrillation in patients with heart failure with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF)?
GLP-1 receptor agonists are associated with a significant reduction in incident atrial fibrillation in patients with HFpEF and HFmrEF, suggesting potential rhythm-modifying benefits.
AIMS: Atrial fibrillation (AF) is more prevalent in heart failure with preserved ejection fraction (HFpEF) than in other heart failure phenotypes and contributes to worse clinical outcomes. Despite structural and metabolic benefits observed with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in HFpEF and heart failure with mildly reduced ejection fraction (HFmrEF), their impact on AF incidence remains unclear. We conducted a meta-analysis of randomized trials to evaluate whether GLP-1 RA therapy reduces incident AF in patients with HFpEF and HFmrEF. METHODS AND RESULTS: = 0.21). Secondary outcomes showed significantly greater reductions in body weight, systolic blood pressure, and left atrial volume in the treatment group. CONCLUSIONS: Glucagon-like peptide-1 receptor agonist therapy is associated with a significant reduction in incident AF among patients with HFpEF and HFmrEF. These findings support the hypothesis that GLP-1 RAs may offer rhythm-modifying benefits in addition to weight and haemodynamic effects. Dedicated HFpEF trials with adjudicated AF outcomes are warranted.
Ravikulan et al. (Sat,) studied this question.
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