Key result
GLP-1 RA use linked to ~69% lower 5-year all-cause mortality in thoracic aortic aneurysm.
Why the study?
GLP-1 receptor agonists may offer vascular protective benefits, but their role in reducing mortality and thoracic aortic dissection risk in patients with TAA had not been evaluated in humans.
Does GLP-1 RA use reduce mortality and thoracic aortic dissection in adults with thoracic aortic aneurysm?
Cohort (n=32,279)
Yes
Does GLP-1 RA use reduce mortality and thoracic aortic dissection in adults with thoracic aortic aneurysm?
Hazard Ratio: 0.31 (95% CI 0.19–0.5)
Absolute Event Rate: 5% vs 14.5%
p-value: p=<0.001
In patients with thoracic aortic aneurysm, GLP-1 RA use is associated with significantly reduced risks of all-cause mortality, cardiovascular mortality, and incident thoracic aortic dissection.
Background/Objectives: Thoracic aortic aneurysm (TAA) often results from structural degeneration of the aortic wall. Traditional management focuses on hemodynamic control using beta-blockers (BB) and angiotensin receptor blockers (ARBs). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for diabetes and weight management, may offer additional vascular protective benefits through anti-inflammatory, antioxidative, and matrix-stabilizing mechanisms. However, their role in reducing mortality and thoracic aortic dissection (TAD) risk in patients with TAA has not been evaluated in human populations. In this study, we aimed to assess the association between GLP-1 RA use and the risks of mortality and thoracic aortic dissection. Methods: We conducted a retrospective cohort study of adults diagnosed with TAA between 2018 and 2024 across three Mayo Clinic sites. Patients receiving GLP-1 RAs were compared with non-users using 1:1 propensity score matching. Outcomes included all-cause mortality, cardiovascular mortality, and incident TAD. Kaplan–Meier and Cox proportional hazards analyses were performed. Results: A total of 32,279 patients with TAA, with a median age of 68.0 [IQR: 59.0–76.0] and 70.7% male, were included in a 1:1 propensity score match. This yielded a balanced cohort of 588 GLP-1 RA users and 588 non-users. Through a median follow-up of 4.1 (2.2, 5.9) years, GLP-1 RA use was associated with significantly lower 5-year cumulative incidence of all-cause mortality (5.0% vs. 14.5%, HR: 0.31; 95% CI: 0.19–0.50; p < 0.001), cardiovascular mortality (1.9% vs. 5.5%, HR: 0.30; 95% CI: 0.13–0.70; p = 0.005), and TAD (0.9% vs. 4.0%, HR: 0.19; 95% CI: 0.06–0.60; p < 0.0004). Conclusions: GLP-1 RAs are associated with reduced incidence of all-cause mortality, cardiovascular mortality, and TAD incidence in patients with TAA. Prospective studies are needed to confirm these findings and evaluate effects on aneurysm progression.
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Raslan et al. (2026) conducted a cohort in Thoracic aortic aneurysm (n=32,279). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) vs. Non-users was evaluated on All-cause mortality (HR 0.31, 95% CI 0.19-0.50, p=<0.001). GLP-1 RA use in patients with thoracic aortic aneurysm was associated with lower 5-year all-cause mortality compared to non-users (5.0% vs. 14.5%; HR 0.31; 95% CI 0.19-0.50; p<0.001).
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