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According to the studies, previous MI is a powerful risk factor for subsequent HFpEF onset

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue

Analysis of subgroup of patients with HF in the EXSCEL trial revelaed that use of once-weekly exenatide reduced the risk of all-cause mortality in patient without HF (HR 0.79 [95% CI, 0.680.92]), while in patients with baseline HF no effect was observed (HR, 1.05 [95% CI, 0.851.29) (67)

Some patients may show genetic patterns suggesting robust GLP-1 pathway activation, which could influence whether adding a DPP-4 inhibitor offers meaningful benefit or represents redundant pathway stimulation

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