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The Association Between Glucagon-like Peptide-1 Receptor Agonists and Clinical Outcomes in Patients with Thoracic

Mohammad Alaa Raslan1,2, Hussein Abdul Nabi1, Luke Dreher1

  • 1Department of Cardiovascular Medicine, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA.

Diagnostics (Basel, Switzerland)
|June 12, 2026
PubMed

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show promise in reducing mortality and thoracic aortic dissection (TAD) risk for patients with thoracic aortic aneurysm (TAA). This study found GLP-1 RA use significantly lowered risks of death and TAD in TAA patients.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Thoracic aortic aneurysm (TAA) involves aortic wall degeneration, typically managed with beta-blockers and ARBs.
  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) possess anti-inflammatory and antioxidative properties, suggesting potential vascular benefits.
  • The impact of GLP-1 RAs on mortality and thoracic aortic dissection (TAD) in TAA patients remains unevaluated.

Purpose of the Study:

  • To investigate the association between GLP-1 RA use and the risks of mortality and TAD in patients diagnosed with TAA.
  • To compare outcomes between TAA patients using GLP-1 RAs and those who are not.

Main Methods:

  • A retrospective cohort study involving 32,279 TAA patients (2018-2024) across three Mayo Clinic sites.
  • 1:1 propensity score matching created balanced cohorts of 588 GLP-1 RA users and 588 non-users.
  • Kaplan-Meier and Cox proportional hazards analyses assessed all-cause mortality, cardiovascular mortality, and incident TAD.

Main Results:

  • GLP-1 RA use was linked to significantly reduced 5-year cumulative incidence of all-cause mortality (5.0% vs. 14.5%, HR: 0.31).
  • Cardiovascular mortality was also lower in GLP-1 RA users (1.9% vs. 5.5%, HR: 0.30).
  • The incidence of thoracic aortic dissection (TAD) was substantially reduced with GLP-1 RA use (0.9% vs. 4.0%, HR: 0.19).

Conclusions:

  • GLP-1 RAs are associated with a decreased incidence of all-cause mortality, cardiovascular mortality, and TAD in patients with TAA.
  • These findings suggest a potential protective role for GLP-1 RAs in managing TAA.
  • Further prospective studies are warranted to confirm these results and explore effects on aneurysm progression.

Keywords:
aortacardiovascular outcomesglucagon-like peptide-1 receptor agonistsmortalitythoracic aortic aneurysmthoracic aortic dissection

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