Sequential incretin therapy to overcome weight plateau in non-ischemic dilated cardiomyopathy: a cardiometabolic strategy

Obesity drives cardiometabolic risk, systemic inflammation, and myocardial remodelling in non- ischemic dilated cardiomyopathy (NICM). GLP-1 and dual GIP/GLP-1 agonists improve weight and metabolic parameters, but weight-loss plateaus are common, posing a management challenge in high- risk patients with HFrEF. Sequential incretin therapy offers a practical strategy to overcome these adaptive plateaus while maintaining cardiovascular stability. rsity-based weight management clinic.