Key result
GLP1-RAs cut major events ~16% in T2D without prior HF but fail in established HF.
Why the study?
The effect of GLP1-RA on heart failure has been inconsistent across T2D trials, and individual trials were underpowered to assess the effect according to heart failure history.
Does GLP1-RA reduce the composite of HF hospitalization or cardiovascular death in stable ambulatory patients with type 2 diabetes with and without heart failure?
Meta-Analysis (n=54,092)
Does GLP1-RA reduce the composite of HF hospitalization or cardiovascular death in stable ambulatory patients with type 2 diabetes with and without heart failure?
Effect estimate: HR 0.96 (with HF); HR 0.84 (without HF) (95% CI 0.84-1.08 (with HF); 0.76-0.92 (without HF))
GLP1-RAs reduce atherosclerotic events regardless of HF history, but only reduce HF hospitalizations and mortality in T2D patients without a prior history of heart failure.
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GLP-1 RAs may not reduce HF hospitalization or CV death in T2D with prior HF; challenges benefit in this subgroup and extends evidence for HF-stratified effects.
Ferreira et al. (2023) conducted a meta-analysis in Type 2 diabetes with and without chronic heart failure (n=54,092). Glucagon-like peptide 1 receptor agonists (GLP1-RA) vs. Placebo was evaluated on Composite of HF hospitalization or cardiovascular death (HR 0.96 (with HF); HR 0.84 (without HF), 95% CI 0.84-1.08 (with HF); 0.76-0.92 (without HF)). GLP1-RA did not reduce HF hospitalization or CV death in T2D patients with HF history (HR 0.96; 95% CI 0.84-1.08), but reduced this outcome in those without HF (HR 0.84; 95% CI 0.76-0.92).
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