{
  "abstract": "Aims: To evaluate the effectiveness of GLP-1 RAs on clinical outcomes in diabetic patients with heart failure with reduced ejection fraction (HFrEF). Methods and results: In this retrospective observational cohort study, all adults with diabetes mellitus and HFrEF between 2014 and 2025 were identified. Patients treated with GLP-1 RAs were matched to controls using stratified exact matching. The primary outcome was a composite of heart failure hospitalization or all-cause mortality. Treatment effects were estimated using nonparametric bootstrap resampling (1,000 iterations) to derive risk ratios, NNT estimates, and corresponding 95% confidence intervals. Time-to-event analyses using Cox proportional hazards models were performed as a validation analysis. Among 7,878 patients with HFrEF, 793 (10.1%) patients who initiated GLP-1 RA therapy after HF diagnosis were matched to 1,825 controls. GLP-1 receptor agonist use was associated with a lower risk of heart failure hospitalization or death, with risk ratios of 0.58 (95% CI: 0.42-0.77) at 12 months and 0.72 (95% CI: 0.61-0.85) at 36 months. The combination of high baseline event rates and substantial relative risk reduction translated into remarkably low NNT values in the overall population, with an NNT of 17 (95% CI: 11-33) at 1 year and 13 (95% CI: 8-25) at 3 years. Post hoc subgroup analyses demonstrated consistent effects across clinical subgroups, with no significant heterogeneity observed. Conclusion: In this large real-world cohort of diabetic patients with HFrEF, GLP-1 receptor agonist therapy, in addition to guideline-directed medical therapy, was associated with a lower risk of death or heart failure hospitalization.",
  "abstract_shown": true,
  "affiliations": [
    "Cardiology Department, Rabin Medical Center, Petah Tikva, Israel; Gray School of Medicine, Tel Aviv University, Tel Aviv, Israel"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Y. Hammer"
    },
    {
      "name": "Y. J. Cohen"
    },
    {
      "name": "R. Arbel"
    },
    {
      "name": "T. Razi"
    },
    {
      "name": "D. Netzer"
    },
    {
      "name": "T. Ben Gal"
    },
    {
      "name": "J. M. Weinstein"
    },
    {
      "name": "Z. Iakobishvili"
    },
    {
      "name": "D. Yamin"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1m90kw8nr78fk.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.03.26367091",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.03.26367091v1.full",
  "id": "1m90kw8nr78fk",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.03.26367091v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "cardiovascular medicine"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.03.26367091v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-03",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1m90kw8nr78fk.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T00:20:38Z",
      "native_id": "10.64898/2026.11.03.26367091",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.03.26367091v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:cardiovascular medicine",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Glucagon-like peptide-1 receptor agonists in diabetic patients with heart failure with reduced ejection fraction - real world outcomes",
  "title_text": "Glucagon-like peptide-1 receptor agonists in diabetic patients with heart failure with reduced ejection fraction - real world outcomes",
  "type": "preprint",
  "updated_at": "2026-11-06T00:20:52Z",
  "url": "https://research.draconitic.com/paper/1m90kw8nr78fk",
  "venue": "medRxiv",
  "versions": []
}