SUN-653 Impact of GLP-1 Agonist on Outcomes in Patients with Heart Failure with Preserved Ejection Fraction and Obesity: A Systematic Review and Meta-Analysis

Abstract Disclosure: A. Ahmed: None. R. Kaddoura: None. T. Almas: None. N. Anavekar: None. Background: There is a recent interest focused on the use of glucagon-like peptide 1 (GLP-1) agonists, which are primarily used for diabetes and weight management, as a potential therapeutic approach for heart failure with persevered ejection fraction (HFpEF). We aim to evaluate the effects of GLP-1 agonists versus placebo on hospitalization rates, functional capacity, and cardiometabolic parameters in patients with HFpEF and obesity. Methods: We performed a systematic review and meta-analysis according to Cochrane handbook for systematic reviews and the preferred reporting items for systematic reviews and meta-analysis. We systematically reviewed three databases: PubMed, Embase, and Scopus, from inception to June 23rd, 2024, to investigate the comparative outcomes between GLP-1 agonist and placebo. Results: We identified 453 articles that were screened at the title and abstract level. We retrieved 14 citations and reviewed them in detail, among which two articles were eligible to be pooled. Hospitalization rates for heart failure were significantly reduced by 71 % (OR 0. 29 95 % CI: 0. 14-0. 58 p=0. 0005 I²=0 %), with GLP-1 agonist indicating a significant impact on lowering the cost of hospital admissions. Furthermore, GLP1 agonists significantly decreased body weight (MD -5. 64 kg 95 % CI: -11. 03 to -0. 25 p=0. 0404 I²=99 and waist circumference (MD -7. 09 cm 95 % CI: -8. 05 to -6. 14 p0. 0001 I²=76 %) demonstrating the positive effects of GLP-1 agonists on body composition. Improvements in functional capacity were evidenced by an increase in the 6-MWD (MD 15.10 m, 95% CI: 14.87-15.34, p<0.0001; I²=0%) (Fig 1 panel D). However, changes in systolic blood pressure were not statistically significant (MD -1.30 mmHg, 95% CI: -4.13 to 1.52, p=0.3660; I²=90%). Conclusion: GLP-1 agonists significantly reduce hospitalization rates and improve weight management and functional capacity in patients with HFpEF. However, further studies are warranted to consolidate these findings, explore the long-term cardiovascular outcomes, and address the cost-effectiveness of GLP-1 agonists. Presentation: Sunday, July 13, 2025