The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2026
The association between glucagon-like peptide 1 receptor agonists therapy and outcomes after heart transplant.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Abbas Mohammed Tiseer, Farina Juan M, Ibrahim Omar H, Ahmed Sherif, Bismee Nadera N, Awad Kamal, Jamal Fares, Sheashaa Hesham, Pereyra Pietri Milagros, Scalia Isabel G, Baba Ali Nima, Attaripour Esfahani Sogol, Abdelfattah Fatmaelzahraa E, Razaghi Mahshad, Mahmoud Ahmed K, Ibrahim Ramzi, Steidley D Eric, Rosenthal Julie L, LeMond Lisa M, Scott Robert L, Hardaway Brian W, Downey Francis X, Sell-Dottin Kristen A, Patel Parag C, Clavell Alfredo L, Ayoub Chadi, Arsanjani Reza
Аннотация
BACKGROUND: Glucagon-like peptide 1 receptor agonists (GLP-1RAs) have demonstrated survival benefits and cardioprotective effects in diabetic and heart failure (HF) patients. However, the association of GLP-1RAs use with mortality and morbidity in heart transplant (HT) recipients has not been previously investigated.
METHODS: All adult patients who underwent HT at three Mayo Clinic sites and survived at least one month after the procedure were assessed. GLP-1RAs use was extracted retrospectively from the electronic medical records (EMR) after the HT. All-cause mortality and hospitalization due to graft dysfunction, graft rejection, vasculopathy, de novo DM, and dialysis were collected and compared between patients exposed and non-exposed to GLP-1RA using Kaplan-Meier curves, cumulative incidence functions, and multivariate Cox regression analyses incorporating GLP-1RA exposure as a time varying covariate.
RESULTS: A total of 1914 patients were included with a median age of 56.3 (46.1, 62.8) years and 71.2% were male. The median follow up was 5.5 (2.2,10.2) years and 285 (14.9%) used GLP-1RAs following HT. In the multivariable time-dependent Cox analysis, GLP-1RA therapy was associated with lower risk of all-cause mortality (HR: 0.33, 95% CI: 0.12 to 0.90; p = 0.031), but not with hospitalization due to graft dysfunction (HR: 0.95, 95% CI: 0.45 to 2.01; p = 0.900) or other outcomes through 5-year follow-up.
CONCLUSIONS: Therapy with GLP-1RAs was associated with a lower risk of all-cause mortality in HT recipients. While the mechanisms of these associations need further investigations, these findings, suggest a potential therapeutic role to improve survival after HT.
METHODS: All adult patients who underwent HT at three Mayo Clinic sites and survived at least one month after the procedure were assessed. GLP-1RAs use was extracted retrospectively from the electronic medical records (EMR) after the HT. All-cause mortality and hospitalization due to graft dysfunction, graft rejection, vasculopathy, de novo DM, and dialysis were collected and compared between patients exposed and non-exposed to GLP-1RA using Kaplan-Meier curves, cumulative incidence functions, and multivariate Cox regression analyses incorporating GLP-1RA exposure as a time varying covariate.
RESULTS: A total of 1914 patients were included with a median age of 56.3 (46.1, 62.8) years and 71.2% were male. The median follow up was 5.5 (2.2,10.2) years and 285 (14.9%) used GLP-1RAs following HT. In the multivariable time-dependent Cox analysis, GLP-1RA therapy was associated with lower risk of all-cause mortality (HR: 0.33, 95% CI: 0.12 to 0.90; p = 0.031), but not with hospitalization due to graft dysfunction (HR: 0.95, 95% CI: 0.45 to 2.01; p = 0.900) or other outcomes through 5-year follow-up.
CONCLUSIONS: Therapy with GLP-1RAs was associated with a lower risk of all-cause mortality in HT recipients. While the mechanisms of these associations need further investigations, these findings, suggest a potential therapeutic role to improve survival after HT.