1892P - Glucagon-like peptide 1 agonists and anthracycline-associated cardiotoxicity in hematologic malignancies

Background

Anthracyclines are the standard first-line treatment in many types of hematologic malignancies but may be associated with adverse cardiovascular effects. Glucagon-like peptide 1 agonists (GLP1a) have been shown to reduce the risk of cardiovascular events in patients with and without type 2 diabetes mellitus (T2DM). However, there is no data testing the effects of GLP1a on cardiovascular outcomes in patients with hematologic malignancies.

Methods

We performed a retrospective, propensity score-matched cohort study using the TriNetX Analytics Network database, a collaborative research platform comprising more than 120 healthcare organizations. Patients who received GLP1a were compared with patients who received other diabetes agents. The efficacy outcome was major adverse cardiovascular events (MACE), which comprised a composite of heart failure, myocardial infarction, and atrial fibrillation/flutter. The safety outcomes were all-cause mortality and serious adverse events associated with GLP1a.

Results

We identified 1636 patients eligible for inclusion, among which 308 patients on a GLP1a were matched to patients on a non-GLP1a. In Cox proportional hazards analyses, patients on a GLP1a had an approximately 50% lower risk of MACE (Hazard ratio (HR), 0.49 [95% CI: 0.26-0.93]) and 60% lower risk of heart failure (HR, 0.42 [95% CI: 0.22-0.81]) than patients on non-GLP1a. We did not detect a difference in the risk of myocardial infarction or atrial fibrillation/flutter. GLP1a were associated with a 40% reduction in all-cause mortality (HR, 0.60 [95% CI: 0.37-0.97]) without an increase in serious adverse events. Table: 1892P

Conclusions

GLP1a were associated with a reduction in MACE, heart failure, and all-cause mortality among patients with T2DM and hematologic malignancies receiving anthracycline therapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

T.G.N. Neilan: Financial Interests, Personal, Speaker, Consultant, Advisor: Bristol Myers Squibb, Genentech, Roivant, Roche, Sanofi, Race Oncology, C4 Therapeutics, CardiolRx, and CRC Oncology; Financial Interests, Personal, Research Grant: Bristol Myers Squibb, Abbott, and AstraZeneca; Financial Interests, Personal and Institutional, Research Grant: National Institutes of Health/NHLBI. All other authors have declared no conflicts of interest.