Effects of GLP ‐1 receptor agonists on incidence and outcomes of ischemic stroke and myocardial infarction: A systematic review and meta‐analysis
Authors' conclusion
GLP-1 RAs demonstrate a protection-in-territory-at-risk pattern with important temporal findings and results translated. These findings support a personalised approach to GLP-1 RA therapy that considers patients' vascular history and risk profiles. The earlier emergence of MI protection and later strengthening of stroke protection deliver significant highlights for clinical expectations and treatment persistence.
Study context
- Population
- RCTs comparing GLP-1 RAs with placebo that reported cerebrovascular and cardiovascular outcomes
- Participants
- 85,373 participants11 RCTs
- Comparison
- GLP-1 RA vs placebo
- Outcome
- Stroke and MI (Hazard Ratios (HRs)) and Territorial Benefit Ratio (TBR = HR stroke/HR MI)
Methodological detailsmeta-regression
- Meta-regression
Pooled result
As reported in the abstract
- Overall balanced
- TBR 1.01 (95% CI 0.89–1.15)
Further pooled results
Stroke, subgroup with prior stroke history
- Prior stroke history provided better stroke protection: HR
- 0.73
- NNT
- 54
Myocardial infarction (MI), subgroup with prior MI history
- Prior MI history provided better MI protection: HR
- 0.79
- NNT
- 55
MI, early protection · first six months
- MI protection emerged earlier: HR
- 0.81
Stroke, later protection · over 24 months
- Stroke protection strengthened over time: HR
- 0.80
Modifiers of territorial protection
- Renal dysfunction, AF and hypertension shifted protection towards stroke; dyslipidemia provided better MI protection
Original publication
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