GLP-1 Agonists & Heart Failure Risk: CHEST 2025 Findings

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GLP-1 Receptor Agonists Show Promise in Reducing Right Heart Failure Risk in PAH Patients

A new analysis indicates that GLP-1 receptor agonists (GLP-1 RAs) may offer a meaningful advantage over sodium-glucose cotransporter-2 inhibitors (SGLT2-i) in protecting the right side of the heart in patients battling pulmonary arterial hypertension (PAH).

A large, real-world analysis revealed that GLP-1 RAs substantially reduced the risk of right heart failure in individuals with PAH compared to those treated with SGLT2-i.This finding suggests a potential shift in therapeutic strategies for managing this severe and progressive disease.

did you know?– PAH affects approximately 500 to 1,000 adults per million each year. Early diagnosis and treatment are crucial for improving patient outcomes and quality of life.

Understanding Pulmonary Arterial Hypertension

PAH is characterized by the remodeling of pulmonary blood vessels and subsequent dysfunction of the right ventricle, the heart’s chamber responsible for pumping blood to the lungs. Both GLP-1 RAs and SGLT2-i have previously demonstrated cardiovascular benefits,particularly in individuals with type 2 diabetes. Researchers initiated this study to determine if these benefits coudl be extended to the PAH patient population.the study followed adults diagnosed with PAH who were receiving treatment with either GLP-1 RAs or SGLT2-i over a period of several years, carefully tracking rates of mortality, respiratory failure, and heart failure.

Pro tip:– BNP levels are a valuable tool for assessing the severity of heart failure. Lower BNP levels generally indicate better heart function and reduced cardiac stress.

Right Heart Function Significantly Improved with GLP-1 RAs

While the study found no statistically significant difference in all-cause mortality (RR 0.906, 95% CI 0.724-1.135) or respiratory failure (RR 0.929, 95% CI 0.689-1.253) between the two treatment groups, a striking difference emerged regarding right heart failure. GLP-1 RAs were associated with a markedly reduced risk of right heart failure compared with SGLT2-i (RR 0.464, 95% CI 0.27-0.798, p = 0.0043).Furthermore, patients in the GLP-1 RA group exhibited significantly lower levels of brain natriuretic peptide (BNP) – averaging 338 compared to 829 in the SGLT2-i group – a key indicator of cardiac stress and right ventricular performance.

Reader question:– Can GLP-1 RAs be used in PAH patients without diabetes? Research suggests potential benefits even in those without type 2 diabetes,but more studies are needed.

Implications for Future PAH Treatment

“This cardioprotective effect highlights a potential new therapeutic direction for PAH,” noted a lead investigator. while overall survival rates remained comparable between the groups, the improved outcomes related to right ventricular function suggest a potential clinical advantage for GLP-1 RAs in this specific patient population. These findings indicate that GLP-1 RAs may provide an added benefit over SGLT2-i in preserving right heart function in individuals with PAH, and further research is warranted to confirm these results in dedicated clinical trials.

The study’s findings were originally published by CHEST and are available at: Related