What if star weight loss drugs, like Ozempic, also had a role to play after a heart attack? Born to treat type 2 diabetes then diverted to lose weight, these GLP-1 agonists are now of great interest to cardiologists. Now, researchers from the University of Bristol and University College London (UK) have shown in animals that GLP-1 drugs improve blood flow in the heart muscle after a heart attack. Published in the journal
Nature Communicationstheir work suggests that they could limit serious complications observed in many patients: enough to raise a lot of hope, and a few questions.
Even before this study, several large trials had already shown that GLP-1 agonists reduce the risk of major cardiovascular events. The international test
SELECTcarried out in more than 17,000 overweight people with cardiovascular disease, found a reduction of approximately 20% in the combined risk of heart attack, stroke or death of cardiac origin under semaglutide, the molecule ofOzempic.
A real-life study in nearly 60,000 elderly patients with type 2 diabetes and atheromatous cardiovascular disease also reported a 23% reduction in major cardiovascular events with semaglutide compared to another treatment. Significant fact: these benefits seem to appear regardless of the weight actually lost using these medications.
“Our latest discoveries are surprising”
Today, Dr Svetlana Mastitskaya, senior lecturer in cardiovascular regenerative medicine at Bristol Medical School: Translational Health Sciences (THS) and lead author of the study, summarizes: “In almost half of all heart attack patients, small blood vessels within the heart muscle remain narrowed, even after the main artery is cleared during emergency medical treatment. This leads to a complication known as ‘no-reflow’, where blood cannot reach certain parts of the heart tissue.”
“Our previous research has shown that this narrowing of blood vessels contributes significantly to ‘no-reflow,’ a complication that increases the risk of death or admission to hospital for heart failure in the year after a heart attack. But our latest findings are surprising in that we found that GLP-1 drugs could prevent this problem,” she continues.
Currently, no protocol recommends Ozempic after a heart attack
In their animal experiments, the current team has shown that these treatments activate potassium channels, release pericytes that constrict capillaries and reopen microvessels that remained blocked after emergency treatment. In the University College London press release, Professor David Attwell, Professor of Physiology at UCL and co-leader of the study, said: “With a growing number of similar GLP-1 drugs now in clinical practice, for conditions ranging from type 2 diabetes and obesity to kidney disease, our results highlight the potential for these existing drugs to be repurposed to treat the risk of ‘no-reflow’ in heart attack patients, offering a potentially life-saving solution.
Please note, for the moment, these results remain preclinical: no protocol recommends Ozempic after a heart attack. In France, semaglutide is reserved for type 2 diabetes, and Wegovy for severe obesity, on medical advice.
What about l’infarct?
Myocardial infarction is the destruction of a more or less extensive area of the heart muscle, irreversible in the absence of urgent treatment. It is the consequence of obstruction of a coronary artery. Risk factors include genetics, age, overweight and obesity, type 2 diabetes, hypertension and cholesterol.
As a reminder, cardiovascular diseases are the leading cause of death worldwide and claim approximately 17.9 million lives each year. In France, it is the second cause of death after cancer.
