April 28, 2025
2 min learn
Key takeaways:
- Diabetes management-dose GLP-1 use reduces recurrent arrhythmic occasions for sufferers with atrial fibrillation and weight problems.
- The best profit was noticed for these with extreme weight problems.
GLP-1 use considerably lowered threat for atrial fibrillation-related occasions for sufferers with diabetes, AF and weight problems, with explicit profit noticed for these with extreme weight problems, a speaker reported.
The outcomes of the multicenter TRANSFORM-AF research have been introduced at Coronary heart Rhythm 2025.
Diabetes management-dose GLP-1 use reduces recurrent arrhythmic occasions for sufferers with atrial fibrillation and weight problems. Picture: Adobe Inventory
“The entire premise of this research is that the residual threat of AF, even post-ablation, is just not trivial, and it’s fairly vital. Nearly one-third of them having recurrence inside a yr. One believable cause for this excessive residual threat is suboptimally managed cardiometabolic threat components, and weight problems is a predominant driver within the Western inhabitants,” Varun Sundaram, MD, PhD, MSc, part chief of superior coronary heart failure on the Louis Stokes Cleveland VA Medical Heart, College Hospitals Harrington Coronary heart & Vascular Institute and affiliate professor of medication at Case Western Reserve College, mentioned throughout a dialogue after the presentation. “That was the premise of the research, the place it’s a pharmacoepidemiologic research throughout the whole Veterans Affairs well being system, the place we investigated the connection between GLP-1 receptor analog use and the burden of atrial fibrillation in sufferers with preexisting AF and weight problems.”
TRANSFORM-AF included 2,510 sufferers with diabetes, AF and weight problems throughout 170 VA hospitals. All sufferers have been assigned a GLP-1 receptor agonist, dipeptidyl-peptidase IV (DPP-IV) inhibitor or sulfonylurea.
The first composite end result was main AF-related occasions, together with hospitalizations for AF, cardioversions and ablation procedures within the GLP-1 teams in contrast with the DPP-IV inhibitor or sulfonylurea comparator group.
Sufferers assigned a GLP-1 receptor agonist have been extra typically older with a better burden of comorbidities in contrast with these handled with DPP-IV inhibition or sulfonylurea.
Throughout a median follow-up of three years, GLP-1 use was related to an roughly 13% decrease threat for main secondary AF-related occasions in contrast with DPP-IV inhibition or sulfonylurea use for sufferers with diabetes, AF and weight problems (HR = 0.87; 95% CI, 0.68-0.96; P = .03).
When the researchers added mortality as a competing threat, they noticed an roughly 15% lowered threat for secondary AF-related occasions with GLP-1 use in contrast with DPP-IV inhibition or sulfonylurea use (HR = 0.85; 95% CI, 0.61-1.03).
The researchers reported observing biggest profit amongst sufferers with BMI greater than 40 kg/m2.
Weight reduction from GLP-1 use within the TRANSFORM trial was reported to be modest, with an roughly 4% larger discount vs. the comparator group.
Varun Sundaram
“Within the absence of randomization, we should always view the findings as hypothesis-generating. … The feasibility of a randomized trial in the way in which all of us would need can be fairly difficult, as we’ll need to randomize sufferers who’re overweight with AF to a management group with no GLP-1 receptor agonists,” Sundaram mentioned throughout the dialogue. “We should always contemplate managing weight problems together with atrial fibrillation by ablations and medicines … [and] use weight problems as a sign to think about using a GLP-1 receptor agonist together with typical remedy for AF.”
Sources/Disclosures
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Selvaganesan P, et al. Late-breaking medical trials and science: Scientific trial updates and registries. Offered at: Coronary heart Rhythm 2025; April 24-27, 2025; San Diego.
Disclosures:
Healio couldn’t verify Sundaram’s related monetary disclosures on the time of publication.
