Association of Glucagon-Like Peptide-1 Receptor Agonists with Cardiovascular Outcomes in Dialysis-Dependent Diabetic Patients with Heart Fai
A target trial emulation study using the TriNetX federated electronic health record network found that glucagon-like peptide-1 receptor agonists are associated with a lower risk of ischemic cardiovascular events and hear
Researchers used the TriNetX federated electronic health record network to emulate a target trial comparing glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in diabetic patients with end-stage kidney disease and heart failure. The study identified a primary population of ESKD-HF patients and applied propensity score matching to balance baseline characteristics. In the primary population, GLP-1RAs were found to be associated with lower risks of ischemic events, heart failure exacerbations, all-cause mortality, and a death-inclusive composite compared to DPP-4i initiation. These findings are consistent across multivariable models, subgroups, and sensitivity analyses, and are corroborated in the confirmatory dialysis-dependence-coded HF subset. The results suggest that GLP-1RAs may improve cardiovascular outcomes in dialysis-dependent diabetic ESKD patients with heart failure.