Efficacy of GLP-1 Agonists and dual GIP/GLP-1 Agonists in Obesity-Related Heart Failure with Preserved Ejection Fraction: A Systematic Review
Efficacy of GLP-1 Agonists and dual GIP/GLP-1 Agonists in Obesity-Related Heart Failure with Preserved Ejection Fraction: A Systematic Review
DOI:
https://doi.org/10.51473/rcmos.v1i2.2025.1731Keywords:
semaglutide, tizepatide, obesity, heart failureAbstract
Objective: To evaluate the efficacy and safety of GLP-1 receptor agonists (Semaglutide) and dual GIP/GLP-1 agonists (Tirzepatide) in the treatment of obesity-related heart failure with preserved ejection fraction (HFpEF). Methods: A systematic review was conducted in PubMed/MEDLINE (2020–2025), including randomized clinical trials specifically targeting HFpEF or reporting relevant cardiovascular outcomes in obese populations. The analysis focused on symptoms, functional capacity, inflammatory markers, and clinical endpoints (cardiovascular death and HF worsening). Results: Five studies met the inclusion criteria: STEP-HFpEF, STEP-HFpEF DM, SELECT, the pooled analysis by Kosiborod MN et al., and SUMMIT. Significant improvements were observed in symptom scores (KCCQ-CSS), along with increased functional capacity and consistent reductions in body weight and inflammation (CRP). Recent trials also suggest a reduction in major clinical events, with hazard ratios ranging from 0.62 to 0.80. Conclusion: GLP-1 agonists and dual GIP/GLP-1 agonists emerge as promising therapies for obesity-related HFpEF, targeting both inflammatory pathophysiology and metabolic modulation. Although the current evidence is robust, additional long-term studies are required for definitive validation.
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Copyright (c) 2025 Vitor Daniel Picinin, Lucca Tessari Balbinott, Ângelo de Melo Spolaor, Agnes Pereira Barachini (Autor)
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