Glucagon-like Peptide-1 Receptor Agonists in Heart Failure: Mechanisms, Evidence and Identifying Optimal Candidates

Nov 14, 2025Cardiac failure review

How Glucagon-like Peptide-1 Receptor Agonists May Help Heart Failure: How They Work, Evidence, and Finding the Best Patients

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Abstract

Glucagon-like peptide-1 receptor agonists () significantly improve symptoms and outcomes in heart failure with preserved ejection fraction () in patients with obesity and/or type 2 diabetes.

  • GLP-1RAs are linked to significant weight loss and blood pressure reduction.
  • Enhanced glycaemic control and anti-inflammatory effects may contribute to heart failure improvement.
  • Dedicated trials confirm the efficacy of GLP-1RAs specifically in HFpEF patients with obesity and/or diabetes.
  • Some trials showed GLP-1RAs significantly improved heart failure symptoms and reduced heart failure events.
  • Current evidence does not support the use of GLP-1RAs for heart failure with reduced ejection fraction.

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Key numbers

3–5 kg
Weight Loss with
Weight loss achieved with shorter-acting .
7.8 points
KCCQ-CSS Improvement
Change in KCCQ-CSS in the STEP- trial vs. placebo.
33%
Hospitalization Risk Reduction
Relative risk reduction in the SUMMIT trial.

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