Thapa Rashmi, Lara-Breitinger Kyla M, Lopez-Jimenez Francisco, Shama Nishat, Egbe Alexander C, Miranda William R, Connolly Heidi M, Jain C Charles, Jokhadar Maan, Kosec Angela M, Alm Svea, Burchill Luke J
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA.
JACC Adv. 2025 Apr;4(4):101674. doi: 10.1016/j.jacadv.2025.101674. Epub 2025 Mar 24.
Obesity is prevalent among patients with adult congenital heart disease (ACHD) and contributes to adverse cardiovascular outcomes. There is a paucity of data regarding glucagon-like peptide-1 receptor agonists (GLP-1 RA) for weight loss in patients with ACHD.
The purpose of this study was to assess the effect, safety, and outcomes of GLP-1 RA among patients with ACHD.
This is a retrospective cohort study of patients with ACHD at Mayo Clinic (January 2013-January 2024) who were prescribed semaglutide or liraglutide. The primary endpoint was weight loss. Secondary endpoints were changes in NYHA functional class, hemoglobin A1c, estimated glomerular filtration rate, and safety endpoints of renal adverse event, hypoglycemia, hospitalization/drug discontinuation due to side effects.
Seventy patients received GLP-1 RA over a mean duration of 21 ± 20 months. Majority (85.7%) had moderate/severe complexity congenital heart disease. Weight loss >5% was achieved in 30 (42.9%) patients. Patients with body mass index ≥35 kg/m were more likely to achieve weight loss >5% [66.7% vs 40%, P = 0.027]. Younger age resulted in improved weight loss of 0.17 kg per 1-year age difference (P = 0.014). Hemoglobin A1c lowered by a mean of 0.6% (P = 0.054). There were no significant changes in NYHA functional class or estimated glomerular filtration rate. One-third of patients experienced side effects, mostly from gastrointestinal intolerance (20%); 11.4% discontinued the medication due to side effects.
GLP-1 RAs are safe and effective for weight loss in patients with ACHD with beneficial effects on glycemic control.
肥胖在成人先天性心脏病（ACHD）患者中普遍存在，并导致不良心血管结局。关于胰高血糖素样肽-1受体激动剂（GLP-1 RA）用于ACHD患者减肥的数据很少。
本研究的目的是评估GLP-1 RA在ACHD患者中的疗效、安全性和结局。
这是一项对梅奥诊所（2013年1月至2024年1月）接受司美格鲁肽或利拉鲁肽治疗的ACHD患者的回顾性队列研究。主要终点是体重减轻。次要终点是纽约心脏协会（NYHA）功能分级、糖化血红蛋白、估计肾小球滤过率的变化，以及肾脏不良事件、低血糖、因副作用住院/停药的安全性终点。
70例患者接受GLP-1 RA治疗，平均疗程为21±20个月。大多数（85.7%）患有中度/重度复杂性先天性心脏病。30例（42.9%）患者体重减轻>5%。体重指数≥35 kg/m²的患者更有可能体重减轻>5%[66.7%对40%，P = 0.027]。年龄越小，每相差1岁体重减轻改善0.17 kg（P = 0.014）。糖化血红蛋白平均降低0.6%（P = 0.054）。NYHA功能分级或估计肾小球滤过率无显著变化。三分之一的患者出现副作用，主要是胃肠道不耐受（20%）；11.4%的患者因副作用停药。
GLP-1 RA对ACHD患者减肥安全有效，对血糖控制有有益作用。
