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Review
. 2025 May 2;13(5):1108.
doi: 10.3390/biomedicines13051108.

Navigating Sarcopenia Risks in GLP-1RA Therapy for Advanced Heart Failure

Winston Wang  1 , Danielle Green  1 , Ramzi Ibrahim  2 , Mahmoud Abdelnabi  2 , Hoang Nhat Pham  3 , Beani Forst  2 , Mohamed Allam  2 , Patrick Sarkis  2 , George Bcharah  4 , Juan Farina  2 , Chadi Ayoub  2 , Dan Sorajja  2 , Reza Arsanjani  2
Affiliations
Review

Navigating Sarcopenia Risks in GLP-1RA Therapy for Advanced Heart Failure

Winston Wang et al. Biomedicines. .

Abstract

Cardiac cachexia (CC) is a severe complication of advanced heart failure (HF), characterized by involuntary weight loss and muscle wasting, leading to poor outcomes and higher mortality. Despite its severity, CC remains under-recognized and undertreated, lacking targeted therapies specifically addressing its pathophysiology. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), though beneficial in reducing cardiovascular risk in patients with HF, may exacerbate muscle wasting in cachectic patients, necessitating further investigation. Non-pharmacological strategies, including tailored nutritional support and exercise programs, have shown positive effects on body composition and quality of life in patients with CC. However, there remains a gap in recommendations tailored to preventive strategies and pharmacologic therapies for patients with CC and concomitant GLP-1RA use. This review highlights the multifactorial mechanisms underlying CC and current and emerging therapeutic approaches for mitigating HF-related sarcopenia while on GLP-1RAs.

Keywords: GLP-1RA; frailty; heart failure; sarcopenia.

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Conflict of interest statement

The authors declare no conflict of interest.

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