GLP-1 drugs are safe and effective for weight loss in adults with congenital heart disease | Research

The takeaway

In 70 adults with congenital heart disease (85.7% moderate/severe complexity), GLP-1 drugs achieved >5% weight loss in 42.9%, with higher BMI and younger age predicting better response, improved HbA1c, and no significant safety concerns over 21 months.

Safe in complex congenital heart disease
GLP-1 drugs achieved meaningful weight loss in ACHD patients with 85.7% moderate/severe heart defects—no cardiac function deterioration or unique safety concerns

What the researchers found

70 ACHD patients; 85.7% moderate/severe complexity. >5% weight loss: 42.9%. BMI≥35: 66.7% achieved >5% loss (p=0.027). Younger age: better response (p=0.014). HbA1c: -0.6%. GI side effects: 20%. Discontinuation: 11.4%. NYHA + eGFR: stable. Mean 21 months.

Why it matters

Adults with congenital heart disease have unique physiological vulnerabilities. Demonstrating GLP-1 drug safety in this population—including those with severe heart defects—fills a critical evidence gap.

How the study worked

Retrospective cohort at Mayo Clinic (Jan 2013-Jan 2024). 70 ACHD patients on semaglutide or liraglutide. Weight loss, NYHA class, HbA1c, eGFR, safety endpoints.

What this study cannot tell us

Retrospective. Small sample (70). Single center. No control group. Mixed GLP-1 drugs. Weight loss response lower than general population.

How to read the evidence

Small retrospective cohort. First-of-its-kind data for ACHD population.

When this study was published

Published in 2025; data 2013-2024.

The bigger picture

As ACHD survival improves, obesity becomes a growing concern in this population. This first study of GLP-1 drugs in ACHD provides the safety data needed for evidence-based prescribing.

Questions still open

Why is weight loss response lower in ACHD versus general population?
Do specific congenital heart defects affect GLP-1 drug response?
Would higher-dose semaglutide or tirzepatide be more effective in ACHD?

Common questions

Can people with congenital heart disease take GLP-1 drugs?

This study suggests yes. Among 70 adults with congenital heart disease (most with moderate to severe defects), GLP-1 drugs produced meaningful weight loss without worsening heart function. About 43% lost more than 5% of their body weight, and HbA1c improved.

Are there special risks for heart disease patients on GLP-1 drugs?

In this study, GLP-1 drugs were well-tolerated. Heart function (NYHA class) and kidney function remained stable. Side effects were similar to the general population—mainly GI symptoms—with about 11% stopping due to intolerance. No unique cardiac concerns were identified.

Read the original research

Glucagon-Like Peptide-1 Agonist Use in Adults With Congenital Heart Disease: Effect, Safety, and Outcomes.

JACC. Advances, 4(4), 101674

View on PubMed ↗Publisher’s paper ↗

Citation

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. (2025). Glucagon-Like Peptide-1 Agonist Use in Adults With Congenital Heart Disease: Effect, Safety, and Outcomes.. JACC. Advances, 4(4), 101674. https://doi.org/10.1016/j.jacadv.2025.101674