Multiple Studies Highlight Wide Spectrum of Cardiovascular Benefits Provided by Anti-Obesity Drugs

According to several studies recently published in the Journal of the American College of Cardiology (JACC), which were also presented at the American Heart Association’s 2024 Scientific Sessions, anti-obesity medications are demonstrating cardiovascular benefits that go beyond weight loss and improve both cardiac structure and function in patients across the cardiovascular disease spectrum.

In a press release from the American College of Cardiology, Harlan M. Krumholz, MD, SM, editor-in-chief of JACC, said “These studies reinforce the potential of GLP-1-based therapies not only to aid in weight loss, but also to transform cardiac health, offering hope for patients living with obesity and cardiovascular disease.”

SUMMIT Trial Secondary Analysis

According to the press release, the SUMMIT study evaluated the impact of FDA-approved tirzepatide, a combined GLP-1 and GIP receptor agonist, on cardiac structure and function in patients with diagnoses of obesity and heart failure with preserved ejection fraction (HFpEF).

In the secondary analysis of the SUMMIT trial, the investigators reviewed data from 106 participants who received imaging for analysis of left ventricular (LV) mass and epicardial adipose tissue (EAT) at baseline and at 52 weeks. In the treatment group, tirzepatide was found to decrease LV mass by 11 g and reduce paracardiac adipose tissue by mL and EAT was decreased in both the treatment and placebo groups.

In reflecting on the results, the investigators explained that the decrease in heart size may contribute to the reduction in heart failure events observed in the main SUMMIT study.

SELECT Trial Secondary Analysis

The press release also highlighted the results of a secondary analysis of the SELECT trial. In the trial, patients who received cardiac bypass surgery and did not have diabetes, but did have a diagnosis of obesity or overweight, were given semaglutide or placebo once per week.

The goal of the trial was to ascertain whether semaglutide treatment improved cardiac outcomes for these patient populations, who are at higher risk for “persistent ischemic events,” because there is a lack of data on improving secondary outcomes for these patients after heart surgery.

According to the press release, the investigators evaluated 2,057 participants who underwent coronary artery bypass grafting (CABG) and 15,547 who did not. The study found that semaglutide use led to “a consistent reduction in major adverse cardiovascular events in both groups, but the absolute risk reduction with semaglutide was greater in those with a history of CABG (2.3% vs 1%).

LookAHEAD Trial Secondary Analysis

Lastly, the press release highlighted a secondary analysis of the LookAHEAD trial, which showed that lifestyle interventions aimed at weight loss for patients with type 2 diabetes changed biomarkers associated with a higher risk for cardiovascular disease and heart failure.

The goal of the trial was to explore how changes in cardiac biomarkers correspond with changes in cardiovascular disease risk, similar to the way weight loss and exercise are already known to reduce cardiovascular disease risk.

According to the study findings, lifestyle interventions reduced high-sensitivity cardiac troponin T (hs-cTnT) at follow-up points of one and four years. In addition, “at one year attenuated at four years,” the investigators observed a rise in N-terminal pro-B-type natriuretic peptide (NT-proBNP).

The press release stated that “changes in these biomarkers are clinically relevant for patients with Type 2 diabetes, as the researchers found that patients with elevated NT-proBNP and hs-cTnT were at greater risk of future ASCVD, and that patients with elevated NT-proBNP were also at greater risk of developing HF [heart failure].”