At the American College of Cardiology’s 74th Annual Scientific Session in Chicago, results from a study by Fretz et al., investigating the impact of glucagon-like peptide-1 receptor agonist (GLP-1RA) use on the incidence of atrial fibrillation (AF) following hospitalisation for heart failure (HF) were released. The development of AF in patients with HF is associated with a significant increase in morbidity and mortality. GLP-1RA therapies have demonstrated a reduction in cardiovascular (CV) risk and improved functionality in patients with preserved-ejection fraction HF, however the impact of GLP-1RAs on the incidence of AF in HF populations remains unknown. There is an increasing demand for GLP-1RAs across the spectrum of cardiometabolic disease and with multiple CV diseases presenting in patients alongside type 2 diabetes (T2D), chronic kidney disease (CKD), obesity, fatty liver etc. The demand to measure clinical outcomes with these therapies, based on their track record of significantly positive results, remains potent.
The study included patients who were admitted to an academic tertiary care center over a 3-year period with a primary diagnosis of HF and no prior diagnosis of AF. In addition, demographic, comorbidity, echocardiography and medication data was obtained and a cox-regression analysis was performed to identify predictors of AF after HF hospitalisation. The authors of the study defined preserved ejection fraction as 40% or greater and the primary outcome was defined as the incidence of AF at one year following discharge. The 519 patients included in the study were all prescribed GLP-1RAs following HF hospitalisation and of these 117 (22.7%) had reduced ejection fraction and 402 (77.3%) had preserved ejection fraction. Results from the study demonstrated that the use of GLP-1RAs is associated with a lower incidence of AF at one year in patients with a preserved ejection fraction (p=0.042; relative risk 0.73; 95% confidence interval: 0.54-99) but not in patients with reduced ejection fractions (p=0.962, relative risk 1.01; 95% confidence interval: 0.65-1.56).
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The use GLP-1RAs is associated with a statistically significant reduction in new onset AF at one year following HF hospitalisation for preserved but not reduced, ejection fraction. GlobalData predicts that studies such as this one will increase the market demand for GLP-1RAs across all areas of cardiometabolic disease, and particularly, the use of GLP-1RAs across the CV disease treatment space.
