GLP-1 Receptor Agonists Halve Cancer Therapy-Related Cardiac Dysfunction Risk in Patients Receiving Cardiotoxic Chemo

Cardiotoxic antineoplastic therapies, while crucial for cancer treatment, frequently lead to cancer therapy-related cardiac dysfunction (CTRCD), a growing concern that significantly impacts long-term survival and quality of life. Current strategies to mitigate CTRCD are often reactive or insufficient, leaving a critical gap in primary prevention. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are well-established for their cardiometabolic benefits in conditions like type 2 diabetes and obesity, but their role in preventing cardiac damage specifically induced by cancer treatments has remained largely unexplored, despite their known anti-inflammatory and cardioprotective properties.

Researchers conducted a large-scale retrospective cohort study using the TriNetX database (2010-2023) to investigate the association between GLP-1 RA use and CTRCD. They identified 711,271 adult cancer patients (≥18 years) without prior heart failure who were receiving cardiotoxic antineoplastic therapy. Patients were divided into GLP-1 RA-exposed and unexposed groups. After propensity score matching, each cohort comprised 19,803 patients. The primary outcome was CTRCD, defined as new-onset heart failure (HF) or initiation of intravenous diuretics. Cox proportional hazard models were employed to assess outcomes at 1 and 3 years.

GLP-1 RA exposure was significantly associated with a reduced risk of CTRCD. At 1 year, the risk was nearly halved, with a Hazard Ratio (HR) of 0.49 (95% CI: 0.45-0.54, p < 0.01). This protective effect persisted at 3 years, showing an HR of 0.56 (95% CI: 0.52-0.61, p < 0.01). The benefits were consistent across various cardiotoxic therapies. Beyond CTRCD, GLP-1 RA use was also linked to significant reductions in other major cardiovascular events. > GLP-1 RA use was associated with reductions in incident HF, all-cause mortality, myocardial infarction, and atrial fibrillation. These positive associations were also observed in patients with metastatic cancer, where GLP-1 RAs lowered risks of CTRCD, all-cause mortality, atrial fibrillation, hospitalizations or emergency room visits, and incident HF.