Impact of GLP-1 receptor agonists on outcomes after heart transplantation

Results from a retrospective, multicenter study, evaluating the association between glucagon-like peptide 1 receptor agonists (GLP‑1RAs) and outcomes after heart transplantation, were published in The Journal of Heart and Lung Transplantation by Abbas et al. Adult heart transplant recipients who survived ≥1 month after transplantation were included (N = 1,914; n = 285 received GLP‑1RAs).

Key data: With a median follow-up of 5.5 years, the 5‑year cumulative incidence of all-cause mortality (ACM) was lower among GLP‑1RA users vs nonusers (2.5% vs 14.5%; p = 0.0001). In multivariable analysis, GLP‑1RA therapy was associated with reduced risk of ACM (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.12–0.90; p = 0.031); with similar findings observed in propensity score-matched analysis (HR, 0.36; 95% CI, 0.13–0.99; p = 0.048). No associations were observed between GLP‑1RA use and hospitalization due to graft dysfunction, graft rejection, dialysis requirement, cardiac allograft vasculopathy, or de novo diabetes mellitus.

Key learning: GLP-1RA therapy was associated with improved survival after heart transplantation without a corresponding reduction in graft-specific complications, suggesting a potential systemic cardiometabolic benefit.