Usage of glucagon-like peptide-1 (GLP-1) agonists in patients with is associated with a 303% lower risk of all-cause mortality at 7 years.
Patients using GLP-1 agonists showed a 28% lower risk of heart failure after 7 years.
The risk of composite cardiovascular events was 41% lower in the GLP-1 agonist group at 7 years.
Clinically significant portal hypertension events were observed to be 54% less likely in patients using GLP-1 agonists after 7 years.
These associations remained consistent over 1-, 3-, 5-, and 7-year follow-ups.
Simplified
(MASLD) is the leading cause of chronic liver disease and is associated with significant cardiovascular morbidity and mortality. This study aims to investigate the association of glucagon-like peptide-1 (GLP-1) agonists with major cardiovascular events, clinically significant portal hypertension events, and all-cause mortality in patients with MASLD. A large, population-based retrospective cohort study was conducted using the TriNetX platform, which provided real-time access to electronic health records of 634,265 adult patients with MASLD/MASH. Propensity score matching (PSM) was employed to create two cohorts: A GLP-1 agonists group and a control group without GLP-1 agonists usage. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models along with Kaplan-Meier survival analyses to estimate outcomes at the end of 1, 3, 5, and 7 years. After PSM, 6,243 patients were included in each group. The GLP-1 agonist group had significantly lower risk of heart failure (at 7 years, HR, 0.721; 95% Cl, 0.593-0.876), composite cardiovascular events (at years 7, HR, 0.594; 95% Cl, 0.475-0.745), clinically significant portal hypertension events (at 7 years, HR, 0.463; 95% Cl, 0.348-0.611), and all-cause mortality (at 7 years, HR, 0.303; 95% Cl, 0.239-0.385). These results were consistent at 1-, 3-, 5-, and 7-years post index event. GLP-1 agonists usage in patients with MASLD is associated with reduced risk of major cardiovascular events, clinically significant portal hypertension, and all-cause mortality. These findings highlight the potential of GLP-1 agonists in MASLD/MASH management, warranting further prospective studies.
Key numbers
0.721
Decrease in Heart Failure Risk
at 7 years for group vs. control group
0.463
Decrease in Risk
at 7 years for group vs. control group
0.303
Decrease in Risk
at 7 years for group vs. control group
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Declarations. Conflict of interest: Dina Halegoua-DeMarzio: Consultant- Pfizer. Research Grant Support- Intercept, Galectin, BMS, Novo Nordisk, Viking, Pfizer; however, this article is solely the author’s work without any connection with Pfizer, Intercept, Galectin, BMS, Novo Nordisk, and Viking. All other authors have no conflict of interests. Ethical approval: Only aggregated counts and statistical summaries of de-identified information without any protected health information are received from participating HCOs, and no study-specific activities are performed in these retrospective analyses; therefore, TriNetX federated network has been granted a waiver from the Western institutional review board, including the Thomas Jefferson institutional review board.
