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Glucagon-like peptide-1 receptor agonists are associated with reduced abdominal aortic aneurysm-related events

Hyunjun Ahn1, David C Kaelber2, Nicholas Hoell3

  • 1Lerner College of Medicine, Cleveland Clinic, Cleveland, OH.

Journal of Vascular Surgery
|November 23, 2025
PubMed
Abstract

Insights

Glucagon-like peptide 1 receptor agonists (GLP-1RAs) significantly reduced mortality, abdominal aortic aneurysm (AAA) repair, and acute abdominal aortic syndrome in patients with unruptured AAA. These findings highlight the potential of GLP-1RAs in managing AAA.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Vascular Surgery

Background:

  • Glucagon-like peptide 1 receptor agonists (GLP-1RAs) demonstrate cardiovascular protective effects.
  • Preclinical studies suggest GLP-1RAs may slow abdominal aortic aneurysm (AAA) growth.
  • Human data on GLP-1RA effects in AAA patients are limited.

Purpose of the Study:

  • To evaluate the impact of GLP-1RAs on all-cause mortality in patients with unruptured AAA.
  • To assess the effect of GLP-1RAs on the need for AAA repair.
  • To determine the influence of GLP-1RAs on acute abdominal aortic syndrome incidence.

Main Methods:

  • Retrospective cohort study using the TriNetX US collaborative network (2015-2020).
  • Identified patients aged ≥18 years with unruptured AAA (ICD-10 codes).
  • Excluded patients with prior AAA rupture, dissection, repair, or connective tissue disorders.
  • Stratified patients by type 2 diabetes (T2D) status.
  • Compared GLP-1RA users with non-users using propensity score matching (1:1).
  • Assessed 5-year outcomes including mortality, AAA repair, and acute abdominal aortic syndrome.

Main Results:

  • Matched cohorts included 1401 T2D patients and 336 non-T2D patients.
  • GLP-1RA use was associated with significantly lower risks of the composite outcome (mortality, AAA repair, acute abdominal aortic syndrome) in both T2D (OR, 0.56) and non-T2D (OR, 0.42) cohorts.
  • GLP-1RA users showed reduced mortality (T2D: OR, 0.54; non-T2D: OR, 0.47) and lower likelihood of AAA repair (T2D: OR, 0.66; non-T2D: OR, 0.45).
  • Kaplan-Meier analysis confirmed the benefits of GLP-1RAs in delaying adverse events.

Conclusions:

  • GLP-1RA prescriptions correlate with a reduced risk of critical events in patients with unruptured AAA.
  • Findings suggest GLP-1RAs may offer benefits in managing AAA.
  • Further research is warranted to investigate GLP-1RAs' direct effects on aneurysm growth and progression.
Keywords:
Abdominal aortic aneurysmAneurysm growthAneurysm repairGlucagon-like peptide receptor agonistsMedical management

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