Glucagon‐Like Peptide‐1 Agonists and the Incidence of Atrial Fibrillation in Obese Patients With Heart Failure With Preserved Ejection Fraction and No Diabetes

ABSTRACT Background Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) reduce cardiovascular risk in obesity, but their effect on atrial fibrillation (AF) in heart failure with preserved ejection fraction (HFpEF) remains unclear. Methods We analyzed TriNetX data comparing obese, non‐diabetic HFpEF patients treated with GLP‐1 RAs ( n = 478) with untreated patients ( n = 6887). Propensity matching yielded 470 patients per cohort. Results GLP‐1 RA therapy was not associated with reduced AF incidence (HR 0.86; 95% CI, 0.53–1.39; p = 0.543) but was associated with lower mortality (HR 0.42; 95% CI, 0.23–0.75; p = 0.003). Conclusions GLP‐1 RAs may not reduce AF incidence in obese, HFpEF patients.