Use of glucagon‐like peptide‐1 receptor agonists in patients with left ventricular assist devices

Oct 13, 2025ESC heart failure

Use of diabetes drugs acting on GLP-1 receptors in patients with heart pumps

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Abstract

Among 1,036 adult recipients, GLP1-RA users had a heart transplantation rate of 18.9%, compared to 8.5% in non-users.

GLP1-RA therapy is associated with higher heart transplantation rates in patients with LVADs (aOR 2.514).
Acute heart failure events were observed less frequently in GLP1-RA users compared to non-users (55.6% vs. 68.9%; aOR 0.565).
All-cause hospitalizations were also lower in the GLP1-RA group (62.5% vs. 75.3%; aOR 0.548).
No significant differences were noted in all-cause mortality, stroke, or cardiac arrest between GLP1-RA users and non-users.

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AIMS: Left ventricular assist devices () are a critical intervention for advanced heart failure (HF), serving as destination therapy or bridge to transplantation. Obesity and diabetes impact outcomes in patients with LVADs. Glucagon-like peptide-1 receptor agonists () demonstrate cardiovascular benefits; however, their role in patients with LVADs remains underexplored. We evaluated the association of GLP1-RA therapy with cardiovascular outcomes in patients with LVADs.

METHODS: This retrospective cohort study used the TriNetX database, a research network database from 98 healthcare organizations. We queried for all adult LVAD recipients (≥18 years) and were stratified into GLP1-RA users and non-users. Propensity score matching (PSM) (1:1) balanced demographics, comorbidities, medication use and laboratory data. Outcomes included heart transplantation rates, heart failure hospitalizations, all-cause mortality, all-cause hospitalizations and cardiovascular events. Logistic regression models were used to estimate adjusted odds ratios (aOR).

RESULTS: After PSM, we included a total of 1036 adult LVAD recipients (518 GLP1-RA users, 518 matched non-users) with a mean follow-up time of 311.6 ± 98.4 days for the GLP1-RA cohort and 304.0 ± 111.5 days for the non-GLP1-RAs cohort. Mean age was 56.7 ± 12.2 years in the GLP1-RA cohort and 58.0 ± 12.5 years in the non-GLP1-RA cohort. Females comprised 28.0% of both cohorts while White patients represented 52.1% of the GLP1-RA group and 53.1% of the non-GLP1-RA group. GLP1-RA users had higher heart transplantation rates [n = 98 (18.9%) vs. n = 44 (8.5%); aOR 2.514 (95% CI: 1.720-3.673)]. Acute HF events and all-cause hospitalizations were lower among GLP1-RA users compared with non-users [n = 288 (55.6%) vs. n = 357 (68.9%); aOR 0.565 (95% CI: 0.438-728) and n = 324 (62.5%) vs. n = 390 (75.3%); aOR 0.548 (95% CI: 0.420-0.716)]. No differences were observed when comparing the GLP1-RA cohort with the non-GLP1-RA cohort in regard to all-cause mortality [n = 32 (6.2%) vs. n = 44 (8.5%); aOR 0.709 (95% CI: 0.442-1.138)], stroke [n = 42 (8.1%) vs. n = 58 (11.2%); aOR 0.700 (95% CI: 0.461-1.062)] or cardiac arrest [n = 18 (3.5%) vs. n = 17 (3.3%); aOR 1.061 (95% CI: 0.541-2.082)].

CONCLUSIONS: GLP1-RA therapy in patients with advanced HF and LVADs is potentially associated with improved heart transplantation rates while decreasing hospitalization and acute HF event rates.

Key numbers

2.514

Increase in Heart Transplantation Rate

Adjusted odds ratio for heart transplantation rates comparing GLP1-RA users vs. non-users.

0.565

Decrease in Acute Heart Failure Events

Adjusted odds ratio for acute heart failure events comparing GLP1-RA users vs. non-users.

0.548

Decrease in

Adjusted odds ratio for comparing GLP1-RA users vs. non-users.

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Use of glucagon‐like peptide‐1 receptor agonists in patients with left ventricular assist devices

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