Novel therapeutic agents for cardiometabolic risk mitigation in heart transplant recipients.

Sonia Garg, Maryjane Farr, Matthias Peltz, Amit Khera, Thomas J Wang, Lauren K Truby, Hadi Beaini, Ananya Gorrai, Patrick O'hara, Nicholas Hendren, Christopher Wrobel, Elizabeth Ashley Hardin, Darren McGuire, Mark Drazner

Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2025;44(4):477-486

PMID: 39701434

Full Text on Elsevier Science View on PubMed

Abstract

Heart transplant (HT) recipients experience high rates of cardiometabolic disease. Novel therapies targeting hyperlipidemia, diabetes, and obesity, including proprotein convertase subtilisin/kexin inhibitors, sodium-glucose cotransporter-2 inhibitors, and glucagon-like peptide-1 agonists, are increasingly used for cardiometabolic risk mitigation in the general population. However, limited data exist to support the use of these agents in patients who have undergone heart transplantation. Herein, we describe the mechanisms of action and emerging evidence supporting the use of novel pharmacologic agents in the post-HT setting for cardiometabolic risk mitigation and review evidence supporting their ability to modulate immune pathways associated with atherogenesis, epicardial adipose tissue, and coronary allograft vasculopathy.

Address: Department of Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.; Sutter Health, Oakland, California.; Department of Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: [email protected].

DOI: 10.1016/j.healun.2024.12.006

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MeSH Terms: Humans, Heart Transplantation, Transplant Recipients, Cardiovascular Diseases