Knowledge
- Therapy with glucagon-like peptide 1 receptor agonists (GLP-1RAs) was not significantly associated with newly occurring arrhythmias overall in patients with type 2 diabetes (T2D) or obesity patients.
- A higher risk of ventricular arrhythmia was observed for higher doses of GLP-1RA.
Why this matters
- GLP-1RAs are recommended for T2D and obesity patients, especially those at high cardiovascular risk.
- Several previous studies have found slightly elevated heart rates with GLP-1RAs, raising concerns about potential arrhythmia risk.
Study design
- Meta-analysis of 56 randomized clinical trials in T2D or obesity patients, including 44,028 treated with GLP-1RAs and 35,692 Control participants.
- The median follow-up was 52 Weeks (range: 24 weeks up to 5.4 years).
- Funding: None
Key results
- The analysis of pooled data from 48 Studies did not show a significant association with the risk of recurrence of atrial fibrillation (AF; relative risk_ [RR]: 0.97; p = 0,65).
- With dulaglutide (10 studies) showed an increasing trend towards new occurrence of AF (RR: 1.40; p = 0.03), while oral semaglutide (5 studies) showed an inverse trend (RR: 0.43; p = 0.02).
- No significant effects were observed for the other GLP-1RAs (albiglutide, exenatide, liraglutide, lixisenatide and subcutaneous semaglutide).
- No overall increased risk of atrial flutter (RR: 0.83; p = 0.96)
- No overall increased risk of ventricular arrhythmias (RR: 1.24; p = 0.16), but an increase at higher doses of GLP-1RA (RR: 1.63; p = 0.01), but not at lower doses (RR: 0.83; p = 0.49)
- No significant increase in sudden cardiac death (RR:& 0.89; p = 0,51)
Constraints
- The overall incidence of arrhythmias was relatively low.
- Data from patients with T2D and patients with obesity were pooled.
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