Role of GLP‐1 Receptor Agonists in Managing Cancer Therapy–Related Cardiac Dysfunction

Background Current anticancer treatments can result in cancer therapy–related cardiac dysfunction (CTRCD). While glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) have demonstrated cardioprotective properties, their role in CTRCD has not been previously explored. Methods This retrospective cohort study utilized the TriNetX research network. Adults aged ≥18 years who had a cancer history and who underwent antineoplastic therapy and developed CTRCD between January 1, 2012 and January 1, 2023 were included. Among patients on guideline‐directed medical therapy for heart failure, 2 groups were identified: GLP‐1 RA users and nonusers. Propensity score matching (1:1) was conducted based on demographics, comorbid conditions, and concurrent medications, yielding a matched sample of 837 patients. Outcomes were assessed over a 1‐year follow‐up period. Results The study cohort found 4982 patients with CTRCD; 837 received GLP‐1 RA therapy (mean age: 69.0 years; 43.8% female; 70.4% White). Compared with nonusers, those treated with GLP‐1 RAs alongside guideline‐directed medical therapy had significantly lower rates of all‐cause mortality (hazard ratio, 0.57 [95% CI, 0.43–0.77]; P <0.001), acute heart failure exacerbations (hazard ratio, 0.69 [95% CI, 0.56–0.85]; P <0.001), and all‐cause hospitalizations (hazard ratio, 0.83 [95% CI, 0.72–0.96]; P =0.009). While reductions in atrial fibrillation/flutter and ventricular tachycardia were observed, they were not statistically significant. Conclusion Among patients with CTRCD receiving guideline‐directed medical therapy, GLP‐1 RA use may be linked to better 1‐year survival and improved heart failure–related outcomes.