GLP-1 receptor agonists are known for their glucose-lowering properties and have previously demonstrated cardioprotective and survival benefits in patients with diabetes and heart failure. However, their role in heart transplant recipients has remained unclear. To address this gap, the researchers conducted a retrospective analysis of adult patients who underwent heart transplantation across three Mayo Clinic centers.
The study included 1,914 adult heart transplant recipients who survived at least one month after transplantation. The median age of the cohort was 56.3 years, and just over 71% were male. Patients were followed for a median duration of 5.5 years, enabling the assessment of both short-term and long-term outcomes. Of the total cohort, 285 patients, accounting for nearly 15%, received GLP-1RA therapy after transplantation.
Investigators extracted data on GLP-1RA use from electronic medical records and evaluated key outcomes, including all-cause mortality and hospitalizations related to graft dysfunction, graft rejection, cardiac allograft vasculopathy, development of new-onset diabetes, and the need for dialysis. Advanced statistical methods, including Kaplan–Meier survival curves, cumulative incidence analyses, and multivariable Cox regression models with time-varying exposure, were used to compare outcomes between patients who received GLP-1RAs and those who did not.
Key Findings:
• After adjustment for potential confounders, GLP-1 receptor agonist therapy was independently linked to a significantly lower risk of all-cause mortality in heart transplant recipients.
• Patients receiving GLP-1RAs experienced nearly a two-thirds reduction in mortality risk compared with those who did not use these agents.
• GLP-1RA use was not associated with either an increased or reduced risk of hospitalization due to graft dysfunction or other transplant-related complications over the five-year follow-up period.
While the exact mechanisms underlying the observed survival benefit remain uncertain, the authors note that GLP-1RAs may exert favorable metabolic, anti-inflammatory, and cardiovascular effects that extend beyond glycemic control. These properties could be particularly relevant in the complex post-transplant setting, where metabolic disorders and cardiovascular risk factors are common.
The findings highlight the potential role of GLP-1 receptor agonists as a therapeutic strategy to improve survival after heart transplantation. The authors emphasize that prospective studies are needed to confirm these associations and to better understand the biological mechanisms driving the observed benefit in this high-risk population.
Reference:
Abbas MT, Farina JM, Ibrahim OH, Ahmed S, Bismee NN, Awad K, Jamal F, Sheashaa H, Pietri MP, Scalia IG, Ali NB, Esfahani SA, Abdelfattah FE, Razaghi M, Mahmoud AK, Ibrahim R, Eric Steidley D, Rosenthal JL, LeMond LM, Scott RL, Hardaway BW, Downey FX, Sell-Dottin KA, Patel PC, Clavell AL, Ayoub C, Arsanjani R. The association between glucagon-like peptide 1 receptor agonists therapy and outcomes after heart transplant. J Heart Lung Transplant. 2026 Jan 9:S1053-2498(26)00003-3. doi: 10.1016/j.healun.2026.01.003. Epub ahead of print. PMID: 41520801.
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