Key result
GLP-1 RA therapy does not impede aerobic endurance or body composition gains during early cardiac rehab.
Why the study?
GLP-1-RAs are associated with loss of muscle mass, raising questions about whether they attenuate improvements in aerobic endurance and body composition during early cardiac rehabilitation.
Does concurrent GLP-1-RA therapy attenuate improvements in aerobic endurance and body composition in cardiac patients participating in an early cardiac rehabilitation program?
Observational (n=64)
Does concurrent GLP-1-RA therapy attenuate improvements in aerobic endurance and body composition in cardiac patients participating in an early cardiac rehabilitation program?
Absolute Event Rate: 114% vs 150%
p-value: p=0.857
Concurrent GLP-1-RA therapy does not impede functional and body composition improvements, including skeletal muscle mass, during early cardiac rehabilitation.
GLP-1-RAs appear compatible with early cardiac rehab gains; hypothesis-generating and requires randomized confirmation before practice change.
Background Glucagon-like-peptide-1-receptor-agonists (GLP-1-RAs) are widely used for glycemic control and weight management in patients with cardiovascular disease. While effective for reducing body fat, these agents are associated with loss of muscle mass. Purpose This study aimed to determine if GLP-1-RAs therapy attenuates improvements in aerobic endurance and body composition in patients participating in an early cardiac rehabilitation (CR) program. Methods We conducted a retrospective, observational study of cardiac patients completing a 3-week early CR program. Median time from cardiac event to CR initiation was 8 days [7–10]. Patients receiving GLP-1-RAs (GLP-1; n=32; mean age: 65 yr; BMI: 33 kg/m²) were propensity-matched for age, sex, body composition, and comorbidities with patients not receiving GLP-1-RAs (noGLP-1; n=32; mean age: 64.5yr; BMI: 31.8kg/m²). Aerobic endurance was assessed by the six-minute walk test (6MWT). Body composition – including body fat mass (BFM), skeletal muscle mass (SMM), and myosteatosis (BFM/SMM ratio) – was measured using bioelectrical impedance analysis. Results Both groups improved significantly in aerobic endurance (GLP-1: +114m [90–176], p<0.001; noGLP-1: +150 m [108–1175], p<0.001), with no between-group difference (p=0.857). No significant differences were found between groups in pre-to-post CR changes for weight (GLP-1: -2.6kg [-6.6– -1.3]; noGLP-1: -3.0kg [-4.4– -1.5]; p=0.971), BFM (GLP-1: -0.9kg [-2.5–0.5]; noGLP-1: -0.45kg [-1.2–0.5]; p=0.214), SMM (GLP-1: -1.0kg [-2.5–0]; noGLP-1: -1.2kg [-2.4– -0.7]; p=0457), or BFM/SMM ratio (GLP-1: -0.01; noGLP-1: +0.03; p=0.248). A negative correlation was observed between myosteatosis and 6MWT at baseline (GLP-1: rho=−0.49; noGLP-1: rho=−0.28) and post-CR (GLP-1: rho=−0.59; noGLP-1: rho=−0.34), without significant differences between groups (baseline: z=−0.93, p=0.35; post-CR: z=−1.21, p=0.23). Conclusion A 3-week, early-initiation CR program improves aerobic endurance and body composition in cardiac patients, with no interference from concurrent GLP-1-RA therapy. Future studies are needed to assess long-term outcomes and explore potential synergistic effects of combined CR and GLP-1RA therapy.
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Riess et al. (2026) conducted an observational in Cardiovascular disease (n=64). GLP-1-RAs vs. No GLP-1-RAs was evaluated on Change in aerobic endurance (6-minute walk test distance) (p=0.857). Concurrent GLP-1-RA therapy did not impede improvements in aerobic endurance (+114m vs +150m; p=0.857) or body composition during a 3-week early cardiac rehabilitation program.
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