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Glucagon-Like Peptide-1 Agonist Use in Adults With Congenital Heart Disease: Effect, Safety, and Outcomes

Rashmi Thapa1, Kyla M Lara-Breitinger1, Francisco Lopez-Jimenez1

  • 1Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.

JACC. Advances
|March 25, 2025
PubMed

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) effectively promote weight loss in adult congenital heart disease (ACHD) patients. These medications are safe and show benefits in glycemic control for this population.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Obesity is a significant concern in adult congenital heart disease (ACHD), worsening cardiovascular outcomes.
  • Limited data exists on the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for weight management in ACHD patients.

Purpose of the Study:

  • To evaluate the effectiveness and safety of GLP-1 RAs for weight loss in patients with ACHD.
  • To assess the impact of GLP-1 RAs on functional class, glycemic control, and renal function in ACHD.

Main Methods:

  • Retrospective cohort study of ACHD patients prescribed semaglutide or liraglutide from January 2013 to January 2024.
  • Primary endpoint: percentage of weight loss. Secondary endpoints: changes in NYHA class, HbA1c, eGFR, and safety events.

Main Results:

  • 42.9% of 70 ACHD patients achieved >5% weight loss with GLP-1 RA treatment over a mean of 21 months.
  • Higher likelihood of weight loss in patients with BMI ≥35 kg/m²; younger age correlated with greater weight loss.
  • GLP-1 RAs demonstrated a trend towards improved glycemic control (HbA1c reduction) with no significant changes in NYHA class or eGFR.

Conclusions:

  • GLP-1 RAs are a safe and effective therapeutic option for weight loss in the ACHD population.
  • GLP-1 RAs offer potential benefits for glycemic control in ACHD patients with obesity.
Abstract

Keywords:
GLP-1 receptor agonistadult congenital heart diseaseweight loss

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