Abstract 4148007: Cardiovascular outcomes with Glucagon-like Peptide-1 receptor agonists and Sodium-glucose Cotransporter-2 Inhibitors in patients with ischemic stroke in the community

• Published in: Circulation (New York, N.Y.) Vol. 150; no. Suppl_1; p. A4148007
• Main Authors: Sheffeh, Mohammad Ali, Estrada Magana, Andres, Medina-Inojosa, Jose, Ortega Aviles, Laura, Bianchettin, Rosana, Medina-Inojosa, Betsy, Klaas, James, Brown, Robert, Lopez-Jimenez, Francisco
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 12.11.2024
• Subjects: Stroke
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.150.suppl_1.4148007

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA) have known cardiovascular benefits. We aimed to assess the efficacy of GLP1-RA or SGLT2i initiation in reducing mortality or cardiovascular events in a community-based cohort of adults with ischemic stroke. Methods: Patients ≥18 years old admitted for acute ischemic stroke between Jan 2000 and June 2022 were identified using the Rochester Epidemiology Project. Subjects were considered exposed to SGLT-2i or GLP1-RA if they were treated with either medication after the index stroke and before the primary (all-cause mortality) or secondary outcomes (MI, recurrent ischemic stroke or composite). Kaplan-Meier curves and Cox models are shown in the Figures. Results: We included 7044 subjects, mean age 72±14 yr, 52% male, 94% white, over a median follow-up of 3 [1-7] years, 416 subjects (6%) had a second stroke, 426 (6%) had an incident MI and 3738 (53%) died. Those on SGLT2i/GLP1-RA had a decreased risk for mortality, incident MI, and composite in the univariate analysis. These associations remained significant after multivariable adjustment and were not affected by minimum time of exposure Figure 1&2. SGLT2i/GLP1-RA use was associated with recurrent ischemic stroke in the multivariate analysis Figure 2C. All associations remained significant in most sub-analyses of individual medications except for the association between GLP1-RA and recurrent stroke Figure 3 Conclusions: SGLT2i or GLP-1 RA use was associated with decreased mortality and risk of myocardial infarction and recurrent stroke in patients with ischemic stroke.