Association Between Glucagon-Like Peptide-1 Receptor Agonists and Risk of Arrhythmias.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), initially designed to treat diabetes mellitus (DM), have demonstrated the potential to mitigate obesity-related cardiovascular risks. However, their effect on arrhythmias is not well established with limited literature. Objective: This study aimed to assess the efficacy of GLP-1 RAs and the risk of cardiac arrest and arrhythmias in obese patients based on real-world evidence. Methods: The TriNetX Global Collaborative Network research database was used to identify obese patients aged ≥ 18 years from January 2020 to December 2022. Patients were categorized into two groups, one with GLP-1 RAs and a control group without GLP-1 RAs. After propensity score matching (PSM), relative risk (RR) was used to compare outcomes over follow-up periods of 1 year and 3 years. Results: After 1:1 PSM, the study cohort comprised 342 753 patients in both groups. The study population had a mean age of 56.35 years. PSM analysis at 1 year follow-up showed that the GLP-1 RAs group of patients had a significantly lower risk of cardiac arrest (RR, 0.33 (95% CI: 0.31-0.37), p < 0.01), atrial fibrillation/flutter (RR, 0.63 (95% CI: 0.60-0.66), p < 0.01), ventricular fibrillation (RR, 0.45 (95% CI: 0.38-0.53), p < 0.01), ventricular tachycardia (RR, 0.56 (95% CI: 0.52-0.60), p < 0.01), second-degree atrioventricular (AV) block (RR, 0.72 (95% CI: 0.63-0.82), p < 0.01), and complete heart block (RR, 0.62 (95% CI: 0.55-0.70), p < 0.01) when compared with the control group. Similar trends were observed for the 3-year follow-up as well. Conclusion: This study suggests that GLP-1 RAs use among obese patients was associated with lower risk of arrhythmias at both 1-year and 3-year follow-ups.