Obesity and Weight Loss Strategies for Patients With Heart Failure.
Study Goal
The researchers aimed to evaluate the safety and efficacy of bariatric surgery for weight loss in patients with heart failure (HFrEF or HFpEF) and its impact on HF hospitalizations and mortality.
Results Summary
Bariatric surgery showed moderate efficacy and safety in patients with preoperative HF or left ventricular dysfunction, with reductions in HF hospitalizations and medium-term mortality. The study also noted encouraging safety and weight loss efficacy of GLP-1 agonists in HFpEF, though concerns remain for advanced HFrEF.
Population
Patients with heart failure (HFrEF or HFpEF) and obesity.
Effective Dosage
Not Assessed
Duration
Not Assessed
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Bariatric surgery | decrease | HF hospitalizations | patients with preoperative HF or left ventricular dysfunction | - | has been associated with reductions | #1 |
Bariatric surgery | decrease | medium-term mortality | patients with preoperative HF or left ventricular dysfunction | - | has been associated with reductions | #2 |
glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide/GLP-1 agonists | increase | weight loss | general population | - | safety and weight loss efficacy seen | #3 |
GLP-1 agonist semaglutide | decrease | obesity | patients with HFpEF | - | confirmed safety and efficacy | #4 |
Obesity is a common comorbidity among patients with heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF), with the strongest pathophysiologic link of obesity being seen for HFpEF. Lifestyle measures are the cornerstone of weight loss management, but sustainability is a challenge, and there are limited efficacy data in the heart failure (HF) population. Bariatric surgery has moderate efficacy and safety data for patients with preoperative HF or left ventricular dysfunction and has been associated with reductions in HF hospitalizations and medium-term mortality. Antiobesity medications historically carried concerns for cardiovascular adverse effects, but the safety and weight loss efficacy seen in general population trials of glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide/GLP-1 agonists are highly encouraging. Although there are safety concerns regarding GLP-1 agonists in advanced HFrEF, trials of the GLP-1 agonist semaglutide for treatment of obesity have confirmed safety and efficacy in patients with HFpEF.