CONGRESS ABSTRACT

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been shown to reduce the risk of major cardiovascular events and cardiovascular death in patients with type 2 diabetes mellitus (T2DM). Recent studies suggest a potential antiarrhythmic effect associated with GLP-1 receptor activation. However, the impact of this drug class on the prevention of complete atrioventricular block (AVB) has not been thoroughly investigated. Objective: This study aimed to evaluate the protective effect of GLP-1 RAs on the risk of complete AVB in patients with T2DM. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched Medline, Embase, and Scopus to identify all randomized controlled trials (RCTs) published up to October 2024 that enrolled T2DM patients comparing the risk of complete AVB in those treated with GLP-1 RAs versus those not treated. The risk of AVB was assessed using the Mantel-Haenszel random effects model, with odds ratios as the effect measure and 95% confidence intervals (CIs). Heterogeneity was evaluated using the Higgins I² statistic. Results: A total of eight RCTs involving 46,194 patients with T2DM were analyzed (23,918 in the GLP-1 RA group and 22,276 in the control group). Patients receiving GLP-1 RAs exhibited a significantly lower risk of complete AVB (OR: 0.58; 95% CI: 0.35 to 0.97; p=0.03; I²: 0%) (Figure 1) compared to those not treated. Visual inspection of the funnel plot indicated potential publication bias. Conclusion: GLP-1 RAs seem to have antiarrhythmic properties in patients with T2DM. These findings further support the pleiotropic effects of these drugs among these vulnerable patients.