GLP-1 Receptor Agonists Versus Empagliflozin or Dapagliflozin in the MASLD-Heart Failure Phenotype: An Exploratory Propensity-Matched Cohort Study
Gautam N, Huynh TM, Truong HH, Duong N (2026). Balkan Medical Journal.
Summary
An observational study of US electronic health records (TriNetX) in adults with metabolic dysfunction-associated steatotic liver disease and heart failure. The primary comparison was semaglutide, liraglutide or dulaglutide against empagliflozin or dapagliflozin, with 8,550 propensity-matched pairs. Mortality was 7.0% in the GLP-1 receptor agonist group and 10.1% in the SGLT2 inhibitor group, and coded acute heart failure diagnoses were also less common in the GLP-1 group (14.2% versus 29.5%). These figures come from routine-care records and show an association, not cause and effect. The authors note that the heart-failure association was stronger in the first 90 days, which makes treatment channeling a plausible explanation, and they say the findings do not support a treatment preference.