The analysis indicates that utilization of GLP-1 medications might potentially avert around 34,000 instances of heart attacks and strokes annually in the United States.
Recent data from pharmaceutical company Novo Nordisk demonstrated that individuals utilizing Wegovy had a 20% decreased risk of cardiac incidents compared to those given a placebo. In March, the United States Food and Drug Administration approved an adjustment to Wegovy's label, enhancing its benefits with regards to cardiovascular health, making it the first weight-loss drug authorized to diminish the risk of heart attacks, strokes, or heart-related fatalities in high-risk patients.
Wegovy belongs to a category of medications called GLP-1 receptor agonists, and its main ingredient, semaglutide, is also approved to manage type 2 diabetes as Ozempic.
Novo Nordisk's trial focused on obese individuals who had a previous heart attack, stroke, or symptoms of peripheral artery disease, such as blocked arteries in the arms or legs.
Fresh research from Dandelion Health, a platform utilizing real-world data and clinical AI to advance personalized care, suggested that GLP-1 drugs could also act as primary prevention, significantly cutting the risk for individuals with mild or moderate cardiovascular disease who hadn't suffered from a cardiac incident.
Utilizing artificial intelligence, researchers analyzed real-world medical records for a group of patients resembling those involved in Novo Nordisk's clinical trial but without a history of major adverse cardiovascular events.
By tracking years of medical history with a particular focus on electrocardiogram readings, or measurements of the heart's electrical activity, the researchers employed an AI model to predict the advantages that GLP-1s could offer in reducing the risk of heart attacks or strokes, which they subsequently validated against actual events.
They discovered that GLP-1s decreased the risk of heart attacks or strokes by 15% to 20%, matching findings from the clinical trial, but for a broader population, potentially benefiting up to 44 million more individuals.
Authors of the study estimated that if everyone in this broader population of eligible patients used GLP-1s, it could lead to 34,000 fewer heart attacks and strokes each year.
"In clinical research, you concentrate on moderate to severe patients because you need fewer patients to demonstrate the efficacy. However, there's a serious danger that you consistently miss the impact of medication on broader populations due to the simple fact that you cannot afford the time or money to study them. This is just a natural flaw of clinical research," said Elliott Green, co-founder and chief executive officer of Dandelion Health.
Artificial intelligence assisted in broadening the scope of analysis, helping capture a group of patients that experts from Dandelion Health regarded as "clinically silent."
GLP-1 drugs have already significantly transformed cardiovascular care, with the potential to use them as a primary prevention method potentially shifting the landscape even more.
"I think about these drugs not as weight loss drugs or even drugs for obesity but as health promoters. They improve health," said Dr. Harlan Krumholz, a cardiologist and scientist at Yale University and Yale New Haven Hospital who was not involved in the new analysis.
More evidence of the advantages of using GLP-1s to treat obesity could be instrumental in convincing individuals, according to Krumholz.
"We could reframe the discussion. It's about trying to get them into a lower-risk category and helping them live a longer and healthier life," Krumholz explained.
Dr. Brendan Everett, a cardiologist at Brigham and Women's Hospital and associate professor at Harvard Medical School, has prescribed GLP-1s for some of his patients.
"As a preventive cardiologist who wants people to be well and has observed the obesity epidemic and what we call cardiometabolic disease consume the United States over the past two or three decades, if you want to deliver good care to your patients, you have to at least think about [GLP-1s] and know how to use them. So, increasingly, I am treating obesity for the sake of treating obesity," Everett stated.
GLP-1s have instigated an "absolute paradigm shift" in caring for people with cardiovascular disease, Everett said. Expanding use to individuals with mild or moderate disease could be advantageous, as long as the costs and goals for prevention are clearly understood.
An analysis published last month in the Health Affairs journal suggested that Medicare coverage of these weight-loss drugs could increase Part D spending by $3 billion, even if just 5% of eligible patients were prescribed one. Preventing heart attacks and strokes can decrease healthcare spending in other ways; research from last year discovered that heart attacks cost hospitals an average of about $19,000.
Clinical trials with randomized controls, such as the one performed by Novo Nordisk, are the gold standard for assessing medication safety and efficacy. AI-driven findings are subject to greater scrutiny before they can be utilized in a more formal drug approvals, but the new research from Dandelion Health highlights some valuable benefits that AI methods can provide.
The analysis by Dandelion Health included a more diverse population than the Novo Nordisk trial, with a more balanced ratio of men and women and nearly three times more patients who were not White.
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The new report also demonstrated a signal more swiftly: The AI model identified decreased cardiovascular risk in patients in less than two years after they initiated taking GLP-1s; the Novo Nordisk trial took more than three years to complete.
Opportunities to improve cardiovascular health in the US are substantial. Heart disease is the leading cause of death in the US, and stroke is fifth.
As the use of GLP-1 drugs increases in popularity, professionals believe that more information could aid healthcare providers in directing the scarce stock towards those who require it most urgently.
Dr. Jody Dushay, an endocrinologist at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School, mentioned to CNN in March that she anticipated the expanded approval of Wegovy, including cardiovascular advantages, to enhance insurance coverage, especially since generic weight-loss drugs may pose heart problems. She also suggested that it could potentially focus the usage of these drugs on those with the highest-risk obesity, who also have cardiovascular diseases.
CNN's Meg Tirrell provided insights to this report.
Wegovy's cardiovascular benefits, demonstrated by Novo Nordisk's trial, could potentially extend to a broader population, reducing the risk of heart attacks and strokes by 15% to 20%. According to Dr. Harlan Krumholz, GLP-1 drugs like Wegovy should be viewed as health promoters, helping individuals improve their overall health and potentially reducing their risk of cardiovascular disease.
