Why the study?
Does risk-based preventive treatment with SGLT2 inhibitors, GLP-1RAs, and nonsteroidal MRAs reduce the projected 10- and 30-year burden of incident heart failure in U.S. adults aged 30-79 years without baseline cardiovascular disease?
Observational
Does risk-based preventive treatment with SGLT2 inhibitors, GLP-1RAs, and nonsteroidal MRAs reduce the projected 10- and 30-year burden of incident heart failure in U.S. adults aged 30-79 years without baseline cardiovascular disease?
Answers are grounded in this paper and cite their sources.
Using the PREVENT equation, risk-based combination therapy with SGLT2 inhibitors, GLP-1RAs, and nonsteroidal MRAs in U.S. adults with a 10-year HF risk >=10% could avert nearly 500,000 heart failure cases over 10 years with an NNT of 14.
Background Several treatments that reduce the risk of heart failure (HF) have been introduced recently. Their impact on the future burden of HF in the U.S. has not been well characterized. Objectives This study aims to estimate the potential impact of recently approved cardiometabolic medications on the future burden of HF in the United States. Methods Using a nationally representative sample of persons in the United States 30-79 years of age without cardiovascular disease at baseline, we used the PREVENT (Predicting Risk of Cardiovascular Disease Events) equation to estimate the 10- and 30-year burden of HF and the projected impact of sodium-glucose cotransporter 2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists on these estimates. The authors estimated the total number of HF cases that could be averted with risk-based treatment and calculated the number needed to treat to prevent HF. Results An estimated 5.5 million (95% CI: 5.1-5.8 million) U.S. adults 30-79 years of age without established cardiovascular disease will develop HF over 10 years. It is estimated to decrease to 5.1 million (95% CI: 4.7-5.4 million) with indicated treatment with a sodium-glucose cotransporter 2 inhibitor, 5.2 million (95% CI: 4.8-5.6 million) with glucagon-like peptide-1 receptor agonists, 5.4 million (95% CI: 5.0-5.7 million) with nonsteroidal mineralocorticoid receptor antagonists, and 4.8 million (95% CI: 4.4-5.2 million) with the use of combination therapy. The use of combination therapy in eligible persons with an estimated 10-year HF risk of ≥10% would result in 6.8 million (95% CI: 6.1-7.5 million) eligible participants, and 498,000 (95% CI: -663,000 to -319,000) fewer cases of HF, with a number needed to treat of 14 (95% CI: 10-22) to prevent 1 incident case. Conclusions The projected burden of HF in the U.S. is substantial. A risk-based approach to preventive treatment may help reduce this considerably. The feasibility of such an approach deserves further investigation.
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Sayed et al. (2026) conducted an observational in Risk of incident heart failure in adults without baseline cardiovascular disease. Sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists (individual and combination therapy) vs. Untreated projected baseline risk was evaluated on Projected 10-year burden of incident heart failure and number of cases averted (NNT 14, 95% CI 10-22).
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