This retrospective cohort study identified 7,878 adults with diabetes and heart failure with reduced ejection fraction, 2014-2025. The 793 who started a GLP-1 receptor agonist after heart failure diagnosis were exactly matched to 1,825 controls. The primary outcome was heart failure hospitalisation or death. Bootstrap risk ratios were 0.58 (95% CI 0.42-0.77) at 12 months and 0.72 (0.61-0.85) at 36 months. The number needed to treat was 17 at one year and 13 at three years, with consistent subgroup effects. Being observational, the study cannot exclude confounding by which patients were prescribed the drugs.
Why it is interesting: It reports GLP-1 receptor agonist use alongside guideline-directed heart failure therapy in routine care. Because baseline event rates were high, the associated absolute difference in hospitalisation or death was large.
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