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Obese patients with HFpEF taking liraglutide experience fewer acute heart failure episodes and lower all-cause mortality.
In a large real-world study, subcutaneous use of liraglutide 3 mg once daily was linked with improved outcomes in patients with heart failure with preserved ejection fraction (HFpEF) and obesity (body mass index [BMI] >30 kg/m²) without diabetes mellitus—highlighting the expanding cardiovascular role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs).
J Kassab and other investigators carried out this retrospective cohort study utilizing deidentified aggregate data from the TriNetX research database. Adults aged ≥18 years with HFpEF, BMI >30 kg/m², and no history of diabetes were included. Patients using other GLP-1 RAs were excluded. Following 1:1 propensity score matching for demographics, BMI, left ventricular ejection fraction (LVEF), medications, and comorbidities, 458 matched patients were analyzed (229 per group). Outcomes were examined over a 2-year follow-up period.
Baseline characteristics were as follows: Mean age 62.8 years; 61.4% female; 75% White; mean HgbA1c 5.69%; mean LVEF 61.4%; mean BMI 37.5 kg/m²; 42% on SGLT2 inhibitors and/or mineralocorticoid receptor antagonists. Compared with matched controls, liraglutide therapy was associated with:
Acute coronary syndromes exhibited a non-significant trend toward reduction (OR 0.477), while stroke risk remained unchanged (OR 1.0). Time-to-event analysis confirmed sustained benefits in survival and heart failure outcomes over 2 years. These findings suggest that liraglutide may yield meaningful cardiovascular benefits in HFpEF patients with obesity but without diabetes, supporting the broader cardiometabolic role of GLP-1 RAs beyond glucose control.
European Heart Journal
Liraglutide in patients with heart failure with preserved ejection fraction and obesity without diabetes
J Kassab et al.
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