SAT-669 Impact of GLP-1 agonist in patients with heart failure and dyslipidemia affected by Metabolic Dysfunction-Associated Steatotic Liver Disease: A prospective case control study

Abstract Disclosure: F.R. Mateo: None. G. Ajenaghughrure: None. G. Polanco: None. K. Rahima: None. A. Vanaparthi: None. A. Mishra: None. S. Kishore: None. F. Ajayi: None. H. Baloch: None. Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) impacts millions worldwide, creating complex health challenges. Glucagon-like peptide-1 (GLP-1) receptor agonists have emerged as a therapeutic option for this metabolic disorder, extending beyond glycemic control and potentially positively impacting multiple systems. Objectives: We sought to investigate the clinical impacts of GLP-1 on MASLD, highlighting its potential to address systemic metabolic dysfunctions and cardiovascular outcomes. Methods: This prospective case-control study utilized data from the TriNetX federated health research network, which comprises electronic health records from 104 healthcare organizations. Adult patients (aged 18-99 years) diagnosed with hyperlipidemia, MASLD, and heart failure were included. Cohort 1 consisted of 6,573 patients treated with glucagon-like peptide-1 (GLP-1) receptor agonists, while Cohort 2 included 24,697 patients who did not receive GLP-1 receptor agonists. Propensity score matching was applied to balance baseline characteristics, resulting in 6,310 matched patients in each cohort. Outcomes were evaluated over a 5-year period following the index event, defined as the first occurrence of the inclusion criteria. Kaplan-Meier survival analysis, hazard ratios (HRs) with 95% confidence intervals (CIs), and log-rank tests were used to compare the cohort outcomes. Results: Cohorts mean age was 71 (SD 11), 50.02% females and 74.08% white. Patients on GLP-1 receptor agonists had a significantly lower risk of mortality (HR 0.511; 95% CI 0.473-0.552; p < 0.001), acute hepatic failure (HR 0.649; 95% CI(0.552, 0.762); p < 0.001), stroke (HR 0.875; 95% CI (0.777, 0.986); p < 0.028), Myocardial infarction (HR 0.753; 95% CI 0.686-0.826; p < 0.001), cardiogenic shock (HR 0.690; 95% CI 0.564-0.844; p < 0.001), cardiac arrest (HR 0.580; 95% CI 0.475-0.709; p < 0.001), peripheral vascular disease (HR 0.825; 95% CI (0.750, 0.906); p < 0.001) and acute kidney failure (HR 0.757; 95% CI 0.757; p < 0.001). Conclusion: These findings indicate that GLP-1 receptor agonists significantly reduce the risk of mortality, cardiovascular events, and other systemic complications in patients with MASLD, hyperlipidemia, and heart failure, with favorable effects across multiple outcomes. This highlights their potential as a multifaceted therapeutic intervention for this high-risk population. Presentation: Saturday, July 12, 2025