类似葡萄糖-1受体激动剂与腹腔大动脉动脉瘤相关事件的减少有关
Hyunjun Ahn1, David C Kaelber2, Nicholas Hoell3
1Lerner College of Medicine, Cleveland Clinic, Cleveland, OH.
Journal of vascular surgery
|November 23, 2025
概括
类似葡萄糖类1受体激动剂 (GLP-1RAs) 显著降低了死亡率,腹腔大动脉动脉瘤 (AAA) 修复和急性腹腔大动脉综合征. 这些发现突显了GLP-1RAs在管理AAA方面的潜力.
科学领域:
- 心血管医学 心血管医学
- 内分泌学 在内分泌学.
- 血管外科 血管外科
背景情况:
- 类似葡萄糖类1受体激动剂 (GLP-1RAs) 显示出心血管保护作用.
- 临床前研究表明GLP-1RAs可能会减缓腹腔大动脉瘤 (AAA) 的生长.
- 对AAA患者GLP-1RA影响的人类数据有限.
研究的目的:
- 评估GLP-1RAs对未破裂AAA患者全因死亡率的影响.
- 评估GLP-1RAs对AAA修复需要的影响.
- 为了确定GLP-1RAs对急性腹腔大动脉综合征发病率的影响.
主要方法:
- 使用 TriNetX 美国协作网络 (2015-2020) 的回顾性队列研究.
- 确定的患者年龄≥18岁,没有破裂的AAA (ICD-10代码).
- 排除了先前有AAA破裂,剖析,修复或结合组织疾病的患者.
- 根据2型糖尿病 (T2D) 状态分层的患者.
- 将GLP-1RA使用者与非使用者进行比较,使用倾向性得分匹配 (1:1).
- 评估了包括死亡率,AAA修复和急性腹腔大动脉综合征在内的5年结果.
主要成果:
- 匹配的队列包括1401名T2D患者和336名非T2D患者.
- 在T2D (OR,0.56) 和非T2D (OR,0.42) 队列中,GLP-1RA使用与复合结局 (死亡率,AAA修复,急性腹腔大动脉综合征) 的风险明显降低.
- GLP-1RA使用者死亡率降低 (T2D:OR,0.54;非T2D:OR,0.47) 和AAA修复的可能性降低 (T2D:OR,0.66;非T2D:OR,0.45).
- 卡普兰-梅尔分析证实了GLP-1RAs在延迟不良事件方面的好处.
结论:
- GLP-1RA的处方与未破裂AAA的患者中关键事件的风险降低相关.
- 研究结果表明,GLP-1RAs在管理AAA时可能有好处.
- 需要进一步的研究来调查GLP-1RAs对动脉瘤生长和进展的直接影响.
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