School of Medicine Publications and Presentations
Document Type
Article
Publication Date
4-2025
Abstract
Background
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown a reduction in major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). However, its efficacy on cerebrovascular events is yet to be well established among diabetic and non diabetic patients.
Objective
We sought to evaluate the efficacy of GLP-1 RAs on stroke risk among its different types in patients with and without Diabetes.
Methods
We performed a systematic literature search on PubMed, EMBASE, and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) from inspection until 15th July 2024, without any language restrictions. Odds ratios (OR) and 95 % confidence intervals (CI) were pooled using a random-effect model, and a p-value of < 0.05 was considered statistically significant.
Results
A total of 11 RCTs with 85,373 patients were included (43,339 in GLP-1 RA and 42,034 in the placebo group) in the analysis. The mean age of the patients in GLP-1 RAs and the placebo groups was 63.5 and 63.1 years, respectively. Pooled analysis of primary and secondary endpoints showed that GLP-1 RAs significantly reduced the risk of incidence of stroke by 15 % (OR, 0.85(95 %CI: 0.77–0.93), P < 0.001) and nonfatal stroke by 13 % (OR, 0.87(95 %CI: 0.79–0.95), P < 0.001) compared with placebo. However, the risk of fatal stroke (OR, 0.94(95 %CI: 0.75–1.17), P = 0.56) was comparable between both groups of patients. Similarly, the risk of serious adverse events such as cerebrovascular accident (OR, 0.75(95 %CI: 0.57–1.00), P = 0.05), hemorrhagic stroke (OR, 0.82(95 %CI: 0.42–1.60), P = 0.57, and ischemic stroke (OR, 0.85(95 %CI: 0.64–1.13), P = 0.26) was comparable between GLP-1RAs and placebo.
Conclusion
Treatment with GLP-1 receptor agonists has beneficial effects in reducing the risk of stroke, and nonfatal stroke in patients with and without diabetes. However, no such effect was observed for fatal stroke.
Recommended Citation
Gera, A., Latif, F., Borra, V., Naz, S., Mittal, V., Ayoobkhan, F. S., ... & Jaiswal, V. (2025). Efficacy of glucagon-like peptide-1 receptor agonists for prevention of stroke among patients with and without diabetes: A meta-analysis with the SELECT and FLOW trails. IJC Heart & Vasculature, 57, 101638. https://doi.org/10.1016/j.ijcha.2025.101638
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Academic Level
resident
Mentor/PI Department
Internal Medicine
Comments
© 2025 The Author(s). This is an open access article under the CC BY license