# GLP-1-receptoragonisten geassocieerd met lagere mortaliteit bij HFrEF

*geplaatst 2026-05-26 · Hartfalen · ESC heart failure · doi 10.1093/eschf/xvag111 · https://hartvaat.nl/2026/04/17/glp-1-receptoragonisten-geassocieerd-met-lagere-mortaliteit-bij-hfref/*

Multicenter retrospectieve cohortstudie (UT Southwestern) van 2.550 propensity score-gematchte patiënten met hartfalen met verminderde ejectiefractie (HFrEF, LVEF ≤40%). Behandeling met semaglutide, tirzepatide of liraglutide was geassocieerd met een 32% lagere 1-jaars totale mortaliteit (7,1% vs 10,2%; OR 0,68; HR 0,54) en minder ziekenhuisopnames voor acuut gedecompenseerd hartfalen (27,7% vs 32,8%; OR 0,79). Er was geen toename van aritmische events (VT/VF, AF/flutter) of nieuwe ACS/CVA. Prospectieve gerandomiseerde studies zijn nodig om deze real-world bevindingen te bevestigen voordat GLP-1-RA bij HFrEF kan worden geadviseerd.

## English: Glucagon-Like Peptide-1 Receptor Agonists in Patients with Heart Failure with Reduced Ejection Fraction.

Multicenter retrospective cohort (UT Southwestern) of 2,550 propensity-matched patients with heart failure with reduced ejection fraction (HFrEF, LVEF ≤40%). GLP-1 receptor agonist therapy (semaglutide, tirzepatide, or liraglutide) was associated with 32% lower 1-year all-cause mortality (7.1% vs 10.2%; OR 0.68; HR 0.54) and fewer acute decompensated heart failure hospitalizations (27.7% vs 32.8%; OR 0.79), without an increase in arrhythmic events or new ACS/stroke. Prospective randomized trials are needed before GLP-1 RAs can be recommended in HFrEF.

## Abstract (original, from the publication)

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) improve cardiovascular outcomes in obesity and HFpEF; however, their safety and efficacy in heart failure with reduced ejection fraction (HFrEF) remain uncertain. AIMS: We sought to evaluate the efficacy and safety of GLP-1 RAs in patients with HFrEF. METHODS: We conducted a multicenter retrospective cohort study of adult patients with HFrEF (LVEF ≤40%) between 2021 and 2024. Patients receiving semaglutide, tirzepatide, or liraglutide were compared with GLP-1RA-naïve patients. Propensity score matching (PSM) (1:1; caliper 0.1) was conducted to balance demographics, comorbidities, LVEF, BMI, HbA1c, and guideline-directed medical therapy. Primary outcomes were 1-year all-cause mortality and acute decompensated HF (ADHF) hospitalizations. Secondary outcomes included new ACS, stroke/TIA, AF/flutter, and VT/VF events. RESULTS: A total of 127,021 patients met inclusion criteria. After PSM, 2,550 patients (n=1,275 per group) were analyzed (mean age 61.5 ±13 years, 33.5% female, 66% White, mean HbA1c 8.1 ±2.1%, mean LVEF 30 ±8.7%, mean BMI 34.5 ±8.4 kg/m2). Patients prescribed GLP-1 RAs had a lower risk of all-cause mortality (7.1% vs 10.2% OR: 0.68, 95% CI: 0.51-0.90; p=0.006). Time-to-event analysis was also consistent (matched HR: 0.54 [95% CI: 0.41-0.7]; p<0.0001). Patients in the GLP-1 RA group also had a lower risk of ADHF (27.7% vs 32.8% OR: 0.79 [95% CI: 0.66-0.93]; p=0.005). New onset ACS, stroke/TIA, AF/flutter, and VT/VF events were similar in both groups. CONCLUSIONS: In this real-world cohort, GLP-1RA therapy in HFrEF was associated with reduced mortality and ADHF without an increase in arrhythmic events. Prospective randomized trials are needed to validate these findings.

Auteurs: Joseph Kassab, Mark H Drazner, Jennifer T Thibodeau

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Bron: ESC heart failure, https://doi.org/10.1093/eschf/xvag111. Bijgewerkt 2026-07-03T13:31:51Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.