Efficacy and safety of GLP-1 receptor agonists in the treatment of obese patients with chronic heart failure: a meta-analysis
- Design
- Meta-analysis · Mixed outcome
- Match to healthy normal-weight adults aged 55–75
- Different population[Auto] Synthesis of studies conducted predominantly in people with obesity/overweight.
- Could weight loss explain it?
- Possibly[Auto] Participants had obesity and/or type 2 diabetes and the abstract does not separate direct drug effects from weight loss or glycaemic improvement.
- Study tier
- Study tier 3Systematic review and meta-analysis of randomized controlled trials only (seven trials in six papers).
- Assessment
- Version 4 · Checked against the source by AI · Oct 19, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
Across 6 papers (7 randomized trials) in people with obesity and chronic heart failure, GLP-1 drugs lowered worsening heart-failure events (OR 0.43) and improved symptom scores, walking distance, BNP and weight, but did not significantly change deaths from any cause, cardiovascular deaths, heart pumping function (LVEF), hs-CRP, or gastrointestinal or serious adverse events.
What the study reported
- Drugs
- Semaglutide, Liraglutide, Dulaglutide, Exenatide, Lixisenatide, Tirzepatide
- Primary outcome
- Not extracted
- Effect
- Not extracted
- 95% confidence interval
- Not extracted
- Follow-up
- Not stated
- Adverse events
- Not extracted
- Limitations
- Not extracted
Who was studied
- Obesity status
- obesity/overweight present (all or most)
- Cvd status
- cardiovascular disease present in population (see abstract)
Study quality details
- Study design
- Meta-analysis
- Sample size
- not extracted
- Randomization
- n/a
- Blinding
- not stated
- Comparator
- not stated
- Follow up duration
- not stated
- Outcome type
- mixed
- Replication
- not assessed (auto)
- Consistency with other evidence
- not assessed (auto)
- Population applicability
- INDIRECT
- Statistical precision
- CI reported: 95% confidence interval (CI
- Risk of bias
- not assessed (auto)
- Peer review status
- yes
How far the review's own results can be trusted
This record is a systematic review, so it is appraised with AMSTAR 2, which rates how far the review's own pooled results can be trusted. It does not grade the trials inside the review; those are appraised one by one.
On this scale High is the best rating. The levels run High, Moderate, Low, Critically low: Critically low confidence in the review is the worst rating a review can receive, and means it should not be relied on for an accurate summary. That is the opposite direction to the risk-of-bias scale used for single trials, where High is the worst.
Critically low confidence in the review · AMSTAR 2 · AI: two passes agreed
Why: 5 critical items fail: review methods set out in a protocol before the review began; list of excluded studies, with reasons; appropriate methods for combining results; risk of bias taken into account when interpreting the results; publication bias investigated and its likely impact discussed.
What it is used for here: Used only to find trials. A review at this level does not supply a pooled result to any outcome in this collection; the trials it lists are appraised on their own.
| Item | Answer |
|---|---|
| 1 Research question and inclusion criteria include the PICO components | No |
| 2 · critical Review methods set out in a protocol before the review began | No — a critical flaw |
| 3 Choice of included study designs explained | No |
| 4 · critical Comprehensive literature search | Partial Yes |
| 5 Study selection done by two reviewers independently | Yes |
| 6 Data extraction done by two reviewers independently | Yes |
| 7 · critical List of excluded studies, with reasons | No — a critical flaw |
| 8 Included studies described in adequate detail | Partial Yes |
| 9 · critical Satisfactory technique for assessing risk of bias in the included studies | Yes |
| 10 Funding of the included studies reported | No |
| 11 · critical Appropriate methods for combining results | No — a critical flaw |
| 12 Effect of risk of bias on the pooled results assessed | No |
| 13 · critical Risk of bias taken into account when interpreting the results | No — a critical flaw |
| 14 Differences between study results explained and discussed | No |
| 15 · critical Publication bias investigated and its likely impact discussed | No — a critical flaw |
| 16 Review authors' conflicts of interest and funding reported | Yes |
Two reviewers assessed the review independently against a written guide (AMSTAR 2 guide, version 1.2), from the full text and retrieved supplements, 2026-10-05.
Funding and conflicts
- Funding
- No financial support received (per full text).
- Industry funded
- Unclear
- Manufacturer
- None identified
- Sponsor role
- not reported in abstract
- Author conflicts
- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
The source, as retrieved
Abstract
[OBJECTIVE] To investigate the efficacy and safety of Glucagon-Like Peptide-1 Receptor Agonists(GLP-1RAs) (Liraglutide, Semaglutide, Exenatide, Dulaglutide, Lixisenatide, and Tirzepatide) in obese patients with chronic heart failure (CHF). [METHOD] A systematic search was performed in 3 databases (Pubmed, Embase, and Cochrane Library) for articles evaluating the effectiveness and safety of GLP-1RAs (Liraglutide, Semaglutide, Exenatide, Dulaglutide, Lixisenatide, and Tirzepatide) for the treatment of obese patients with CHF from the time the database was created until 5 January 2025. Meta-analyses were performed to evaluate: primary outcomes, including all-cause mortality, cardiovascular mortality, and worsening heart failure events; secondary outcomes, encompassing changes in body weight, Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS), 6-minute walk distance, B-type Natriuretic Peptide (BNP) level, high-sensitivity C-Reactive Protein (hs-CRP) level, and left ventricular ejection fraction (LVEF) level; and safety outcomes, specifically gastrointestinal adverse events and serious adverse events. [RESULTS] A total of 6 papers were included for Meta-analysis. The primary clinical outcomes: all-cause mortality [OR=0.89, 95% confidence interval (CI): 0.40-2.00, p = 0.78], cardiovascular mortality (OR = 0.93, 95% CI: 0.22-4.00, p = 0.92) and worsening heart failure events (OR=0.43, 95% CI: 0.30-0.59, p < 0.00001); For secondary outcomes, change in body weight (MD = -7.90, 95% CI: -15.44 to -0.35, p = 0.04), change in the KCCQ-CSS (MD = 6.81, 95% CI: 6.62-6.99, p < 0.00001),change in the 6-minute walk distance (MD = 15.91, 95% CI: 15.36-16.47, p < 0.00001), change in the BNP level (MD = -0.13, 95% CI: -0.21 to -0.05, p = 0.001), changes in the hs-CRP level (MD = -16.61, 95% CI: -48.53 to 15.31, p = 0.31) and change in the LVEF level (MD = -0.91, 95% CI: -2.12 to 0.29, p = 0.14). For safety outcomes, gastrointestinal adverse events (OR=0.87, 95% CI: 0.11-7.05, p = 0.90) and serious adverse events (OR=0.63, 95% CI: 0.37-1.08, p = 0.09). [CONCLUSION] The study results show that GLP-1RAs significantly reduce the risk of worsening heart failure events and improve cardiac function, suggesting that GLP-1RAs are promising treatment options for obese patients with CHF.