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Abstract
Glycaemic improvement accounts for less than 20% of the reduction in major adverse cardiovascular events achieved by incretin-based therapies.
- Incretin-based therapies include selective GLP-1 receptor agonists, dual GLP-1/GIP agonists, and unimolecular triple agonists.
- These therapies may positively impact cardiovascular health through mechanisms beyond glycaemic control.
- Factors contributing to cardiovascular benefits include weight reduction, lipid changes, blood pressure lowering, and reduced systemic inflammation.
- Incretin signaling is linked to enhanced energy production in cells, activation of protective responses, and prevention of heart cell death.
- Isolated human atrial studies indicate that GLP-1 receptor agonists and triple agonists have direct positive effects on heart muscle contraction.
- Evidence from cardiac imaging highlights reverse changes in heart structure with tirzepatide in patients with obesity-related heart failure.
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