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The potential of glucagon-like peptide-1 receptor agonists in heart failure

Heart failure (HF) remains one of the cardiovascular diseases (CVDs) associated with a high unmet medical need due to high morbidity and mortality rates and lack of efficacious interventions. HF is closely related to cardiometabolic diseases such as diabetes, obesity and chronic kidney disease, and...

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Autores principales: Kreiner, Frederik Flindt, Hovingh, G. Kees Kornelis, von Scholten, Bernt Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531309/
https://www.ncbi.nlm.nih.gov/pubmed/36203939
http://dx.doi.org/10.3389/fphys.2022.983961
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author Kreiner, Frederik Flindt
Hovingh, G. Kees Kornelis
von Scholten, Bernt Johan
author_facet Kreiner, Frederik Flindt
Hovingh, G. Kees Kornelis
von Scholten, Bernt Johan
author_sort Kreiner, Frederik Flindt
collection PubMed
description Heart failure (HF) remains one of the cardiovascular diseases (CVDs) associated with a high unmet medical need due to high morbidity and mortality rates and lack of efficacious interventions. HF is closely related to cardiometabolic diseases such as diabetes, obesity and chronic kidney disease, and strategies that address most or all these intertwined conditions are desirable. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are approved for type 2 diabetes (T2D), and some are also indicated for reduction of the risk of atherosclerotic CVD in T2D and for weight management. As we summarise in this concise review, preliminary evidence suggests that the cardioprotective benefits of GLP-1 RAs may also extend to HF. The most robust clinical evidence arguably originates from the large cardiovascular outcomes trials (CVOTs) completed for most GLP-1 RAs, of which the latest showed a significant relative risk reduction (RRR) of 39% (HR) with once-weekly efpeglenatide on HF requiring hospitalisation, corroborating a meta-analysis which found a significant RRR across eight GLP-1 RA CVOTs of 11%. Further, although incompletely described, multiple studies are available to provide insights into the mechanistic underpinnings, which appear to be associated mostly with indirect cardioprotective benefits owing to the ability of GLP-1 RAs to address hyperglycaemia, and reduce body weight, and, amongst others, inflammation. In sum, current evidence positions GLP-1 RAs as a potential cardioprotective strategy in HF, with HF with preserved ejection fraction emerging as the clinically most relevant phenotype for the drug class, especially when occurring in people with obesity with and without diabetes.
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spelling pubmed-95313092022-10-05 The potential of glucagon-like peptide-1 receptor agonists in heart failure Kreiner, Frederik Flindt Hovingh, G. Kees Kornelis von Scholten, Bernt Johan Front Physiol Physiology Heart failure (HF) remains one of the cardiovascular diseases (CVDs) associated with a high unmet medical need due to high morbidity and mortality rates and lack of efficacious interventions. HF is closely related to cardiometabolic diseases such as diabetes, obesity and chronic kidney disease, and strategies that address most or all these intertwined conditions are desirable. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are approved for type 2 diabetes (T2D), and some are also indicated for reduction of the risk of atherosclerotic CVD in T2D and for weight management. As we summarise in this concise review, preliminary evidence suggests that the cardioprotective benefits of GLP-1 RAs may also extend to HF. The most robust clinical evidence arguably originates from the large cardiovascular outcomes trials (CVOTs) completed for most GLP-1 RAs, of which the latest showed a significant relative risk reduction (RRR) of 39% (HR) with once-weekly efpeglenatide on HF requiring hospitalisation, corroborating a meta-analysis which found a significant RRR across eight GLP-1 RA CVOTs of 11%. Further, although incompletely described, multiple studies are available to provide insights into the mechanistic underpinnings, which appear to be associated mostly with indirect cardioprotective benefits owing to the ability of GLP-1 RAs to address hyperglycaemia, and reduce body weight, and, amongst others, inflammation. In sum, current evidence positions GLP-1 RAs as a potential cardioprotective strategy in HF, with HF with preserved ejection fraction emerging as the clinically most relevant phenotype for the drug class, especially when occurring in people with obesity with and without diabetes. Frontiers Media S.A. 2022-09-20 /pmc/articles/PMC9531309/ /pubmed/36203939 http://dx.doi.org/10.3389/fphys.2022.983961 Text en Copyright © 2022 Kreiner, Hovingh and von Scholten. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Kreiner, Frederik Flindt
Hovingh, G. Kees Kornelis
von Scholten, Bernt Johan
The potential of glucagon-like peptide-1 receptor agonists in heart failure
title The potential of glucagon-like peptide-1 receptor agonists in heart failure
title_full The potential of glucagon-like peptide-1 receptor agonists in heart failure
title_fullStr The potential of glucagon-like peptide-1 receptor agonists in heart failure
title_full_unstemmed The potential of glucagon-like peptide-1 receptor agonists in heart failure
title_short The potential of glucagon-like peptide-1 receptor agonists in heart failure
title_sort potential of glucagon-like peptide-1 receptor agonists in heart failure
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531309/
https://www.ncbi.nlm.nih.gov/pubmed/36203939
http://dx.doi.org/10.3389/fphys.2022.983961
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