Why the study?
GLP1-RAs demonstrate cardiovascular benefits, but their role in patients with LVADs remains underexplored despite obesity and diabetes impacting LVAD outcomes.
Does GLP1-RA therapy improve heart transplantation rates and reduce hospitalizations in adult LVAD recipients?
Does GLP1-RA therapy improve heart transplantation rates and reduce hospitalizations in adult LVAD recipients?
In adult LVAD recipients, GLP1-RA use is associated with higher rates of heart transplantation and lower rates of heart failure hospitalizations.
Aims Left ventricular assist devices (LVADs) are a critical intervention for advanced heart failure (HF), serving as destination therapy or bridge to transplantation. Obesity and diabetes impact outcomes in patients with LVADs. Glucagon‐like peptide‐1 receptor agonists (GLP1‐RAs) demonstrate cardiovascular benefits; however, their role in patients with LVADs remains underexplored. We evaluated the association of GLP1‐RA therapy with cardiovascular outcomes in patients with LVADs. Methods This retrospective cohort study used the TriNetX database, a research network database from 98 healthcare organizations. We queried for all adult LVAD recipients (≥18 years) and were stratified into GLP1‐RA users and non‐users. Propensity score matching (PSM) (1:1) balanced demographics, comorbidities, medication use and laboratory data. Outcomes included heart transplantation rates, heart failure hospitalizations, all‐cause mortality, all‐cause hospitalizations and cardiovascular events. Logistic regression models were used to estimate adjusted odds ratios (aOR). Results After PSM, we included a total of 1036 adult LVAD recipients (518 GLP1‐RA users, 518 matched non‐users) with a mean follow‐up time of 311.6 ± 98.4 days for the GLP1‐RA cohort and 304.0 ± 111.5 days for the non‐GLP1‐RAs cohort. Mean age was 56.7 ± 12.2 years in the GLP1‐RA cohort and 58.0 ± 12.5 years in the non‐GLP1‐RA cohort. Females comprised 28.0% of both cohorts while White patients represented 52.1% of the GLP1‐RA group and 53.1% of the non‐GLP1‐RA group. GLP1‐RA users had higher heart transplantation rates [ n = 98 (18.9%) vs. n = 44 (8.5%); aOR 2.514 (95% CI: 1.720–3.673)]. Acute HF events and all‐cause hospitalizations were lower among GLP1‐RA users compared with non‐users [ n = 288 (55.6%) vs. n = 357 (68.9%); aOR 0.565 (95% CI: 0.438–728) and n = 324 (62.5%) vs. n = 390 (75.3%); aOR 0.548 (95% CI: 0.420–0.716)]. No differences were observed when comparing the GLP1‐RA cohort with the non‐GLP1‐RA cohort in regard to all‐cause mortality [ n = 32 (6.2%) vs. n = 44 (8.5%); aOR 0.709 (95% CI: 0.442–1.138)], stroke [ n = 42 (8.1%) vs. n = 58 (11.2%); aOR 0.700 (95% CI: 0.461–1.062)] or cardiac arrest [ n = 18 (3.5%) vs. n = 17 (3.3%); aOR 1.061 (95% CI: 0.541–2.082)]. Conclusions GLP1‐RA therapy in patients with advanced HF and LVADs is potentially associated with improved heart transplantation rates while decreasing hospitalization and acute HF event rates.
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Ibrahim et al. (2025) studied this question.
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