{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:53:13Z","timestamp":1793749993849,"version":"4.6.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) improve cardiovascular outcomes in obesity and heart failure and preserved ejection fraction; however, their safety and efficacy in heart failure with reduced ejection fraction (HFrEF) remain uncertain. We sought to evaluate the efficacy and safety of GLP-1RAs in patients with HFrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicentre retrospective cohort study of adult patients with HFrEF (LVEF \u226440%) between 2021 and 2024. Patients receiving semaglutide, tirzepatide, or liraglutide were compared with GLP-1RA-na\u00efve patients. Propensity score matching (PSM) (1:1; caliper 0.1) was conducted to balance demographics, comorbidities, LVEF, body mass index (BMI), haemoglobin A1c (HbA1c), and guideline-directed medical therapy. Primary outcomes were 1-year all-cause mortality and acute decompensated HF (ADHF) hospitalizations. Secondary outcomes included new acute coronary syndrome (ACS), stroke\/transient ischaemic attack (TIA), atrial fibrillation (AF)\/flutter, and ventricular tachycardia (VT)\/ventricular fibrillation (VF) events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 127 021 patients met inclusion criteria. After PSM, 2550 patients (n = 1275 per group) were analysed (mean age 61.5 \u00b1 13 years, 33.5% female, 66% White, mean HbA1c 8.1 \u00b1 2.1%, mean LVEF 30 \u00b1 8.7%, mean BMI 34.5 \u00b1 8.4\u2005kg\/m2). Patients prescribed GLP-1RAs had a lower risk of all-cause mortality [7.1% vs 10.2%, odds ratio (OR): 0.68, 95% confidence interval (CI): 0.51\u20130.90; P = .006]. Time-to-event analysis was also consistent [matched hazard ratio: 0.54 (95% CI: 0.41\u20130.7); P &amp;lt; .0001]. Patients in the GLP-1RA group also had a lower risk of ADHF [27.7% vs 32.8% OR: 0.79 (95% CI: 0.66\u20130.93); P = .005]. New onset ACS, stroke\/TIA, AF\/flutter, and VT\/VF events were similar in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real-world cohort, GLP-1RA therapy in HFrEF was associated with reduced mortality and ADHF without an increase in arrhythmic events. Prospective randomized trials are needed to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag111","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:40:29Z","timestamp":1776253229000},"source":"Crossref","is-referenced-by-count":3,"title":["Glucagon-like peptide-1 receptor agonists in patients with heart failure with reduced ejection fraction"],"prefix":"10.1093","volume":"13","author":[{"given":"Joseph","family":"Kassab","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, UT Southwestern Medical Center , Dallas, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H","family":"Drazner","sequence":"additional","affiliation":[{"name":"Division of Cardiology, UT Southwestern Medical Center , 5323 Harry Hines Blvd, Dallas, TX 75390 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer T","family":"Thibodeau","sequence":"additional","affiliation":[{"name":"Division of Cardiology, UT Southwestern Medical Center , 5323 Harry Hines Blvd, Dallas, TX 75390 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"2026052914372908300_xvag111-B1","doi-asserted-by":"publisher","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","article-title":"Semaglutide and cardiovascular outcomes in obesity without diabetes","volume":"389","author":"Lincoff","year":"2023","journal-title":"N Engl J Med"},{"key":"2026052914372908300_xvag111-B2","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1056\/NEJMoa2306963","article-title":"Semaglutide in patients with heart failure with preserved ejection fraction and obesity","volume":"389","author":"Kosiborod","year":"2023","journal-title":"N Engl J 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placebo-controlled trial","volume":"19","author":"Jorsal","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026052914372908300_xvag111-B6","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000450","article-title":"Contributory risk and management of comorbidities of hypertension, obesity, diabetes Mellitus, hyperlipidemia, and metabolic syndrome in chronic heart failure: a scientific statement from the American Heart Association","volume":"134","author":"Bozkurt","year":"2016","journal-title":"Circulation"},{"key":"2026052914372908300_xvag111-B7","doi-asserted-by":"publisher","first-page":"102489","DOI":"10.1016\/j.jchf.2025.03.035","article-title":"GLP-1 receptor agonists in heart failure with reduced ejection fraction: meta-analysis of randomized clinical trials","volume":"13","author":"Neves","year":"2025","journal-title":"JACC Heart 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