Key result
Adding GLP-1 RAs to GDMT links to ~43% fewer major events in cancer therapy-related cardiac dysfunction.
Why the study?
GLP-1 RAs have cardioprotective effects, but their impact on cancer therapy-related cardiac dysfunction has not been evaluated.
Does adding GLP-1 receptor agonists to guideline-directed medical therapy reduce mortality, hospitalization, and heart failure exacerbations in patients with cancer therapy-related cardiac dysfunction?
Cohort (n=2,446)
Yes
Does adding GLP-1 receptor agonists to guideline-directed medical therapy reduce mortality, hospitalization, and heart failure exacerbations in patients with cancer therapy-related cardiac dysfunction?
The addition of GLP-1 receptor agonists to standard heart failure therapy in patients with cancer therapy-related cardiac dysfunction is associated with significantly improved 1-year mortality and heart failure outcomes.
May support GLP-1 RA addition to GDMT in cancer therapy-related cardiac dysfunction; leaves open confirmation by randomized trials.
Background Anti-cancer therapies currently available can lead to cancer therapy-related cardiac dysfunction (CTRCD). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been shown to exhibit cardioprotective effects but its impact on CTRCD has not been evaluated. Objectives This study evaluates the impact of GLP-1 RAs on all-cause mortality, hospitalization, and heart failure exacerbation in patients with CTRCD. Methods This is a retrospective cohort analysis using the TriNetX research network. Patients aged ≥18 years with a history of cancer who received antineoplastic therapies and subsequently developed cancer therapy-related cardiac dysfunction (CTRCD) between January 1, 2012, and January 1, 2023, were included. Patients receiving guideline-directed medical therapy (GDMT) for heart failure were divided into two groups: those using GLP-1 RAs and those not using them. Propensity score matching (1:1) was applied based on demographics, comorbidities, and medications, resulting in a matched cohort of 1,223 patients. Outcomes over a 1-year follow-up were measured. Results The study cohort found 12,410 patients with CTRCD of which 1,223 had received GLP-1 RA treatment (mean age: 66.4 years; 47.3% female; 65.9% White). Patients receiving GLP-1 RAs in addition to GDMT had a significantly lower risk of acute heart failure exacerbations, all-cause mortality, and all-cause hospitalization (OR: 0.566 [95% CI: 0.48-0.668]; P < 0.001). A clinically significant reduction in atrial fibrillation/flutter and ventricular tachycardia was observed in the GLP-1 RA groups, although did not reach statistical significance. Conclusion In patients with CTRCD, adding GLP-1 RA therapy to GDMT significantly improves mortality and heart failure outcomes over 1 year.
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Vignarajah et al. (2025) conducted a cohort in Cancer therapy-related cardiac dysfunction (CTRCD) (n=2,446). GLP-1 receptor agonists vs. Guideline-directed medical therapy without GLP-1 receptor agonists was evaluated on Composite of heart failure exacerbation, all-cause mortality, and all-cause hospitalization or emergency department visits (OR 0.566, 95% CI 0.480-0.668, p=<0.001). In patients with cancer therapy-related cardiac dysfunction, adding GLP-1 receptor agonists to guideline-directed medical therapy significantly reduced the composite risk of heart failure exacerbation, mortality, and hospitalization (OR 0.566).
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