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
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 pa...
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Elsevier
2025-04-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906725000417 |
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| author | Asmita Gera Fakhar Latif Vamsikalyan Borra Sidra Naz Vivek Mittal Fathima Shehnaz Ayoobkhan Tushar Kumar Zarghoona Wajid Novonil Deb Tanisha Prasad Jishanth Mattumpuram Vikash Jaiswal |
| author_facet | Asmita Gera Fakhar Latif Vamsikalyan Borra Sidra Naz Vivek Mittal Fathima Shehnaz Ayoobkhan Tushar Kumar Zarghoona Wajid Novonil Deb Tanisha Prasad Jishanth Mattumpuram Vikash Jaiswal |
| author_sort | Asmita Gera |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-4d91f8ae09044cfe86700f3ec56b5127 |
| institution | DOAJ |
| issn | 2352-9067 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-4d91f8ae09044cfe86700f3ec56b51272025-08-20T03:01:42ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-04-015710163810.1016/j.ijcha.2025.101638Efficacy 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 trailsAsmita Gera0Fakhar Latif1Vamsikalyan Borra2Sidra Naz3Vivek Mittal4Fathima Shehnaz Ayoobkhan5Tushar Kumar6Zarghoona Wajid7Novonil Deb8Tanisha Prasad9Jishanth Mattumpuram10Vikash Jaiswal11Department of Internal Medicine, Tianjin Medical University, Wuqing District, Tianjin 301700, ChinaDepartment of Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Internal Medicine, The University of Texas Rio Grande Valley, Edinburg, Texas, USAThe University of Texas, MD Anderson Cancer Center, Texas, USADepartment of Internal Medicine, Trinity Health Oakland/Wayne State University, MI, USADepartment of Internal Medicine, Trinity Health Oakland/Wayne State University, MI, USADepartment of Cardiothoracic and Abdominal Radiology, University of Washington, Seattle, Washington, USAHennepin Healthcare/University of Minnesota, S8, Minneapolis, MN 55415, USADepartment of Medicine, North Bengal Medical College, West Bengal, IndiaDepartment of Medicine, Royal College of Surgeons, Dublin, Ireland; Corresponding author at: Department of Medicine, Royal College of Surgeons, Dublin, Ireland.Division of Cardiology, University of Louisville School of Medicine, KY 40202, United StatesDepartment of Cardiovascular Research, Larkin Community Hospital, South Miami, FL, USABackground: 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.http://www.sciencedirect.com/science/article/pii/S2352906725000417GLP-1 RADiabetesStrokeMeta-analysisOutcomes |
| spellingShingle | Asmita Gera Fakhar Latif Vamsikalyan Borra Sidra Naz Vivek Mittal Fathima Shehnaz Ayoobkhan Tushar Kumar Zarghoona Wajid Novonil Deb Tanisha Prasad Jishanth Mattumpuram Vikash Jaiswal 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 International Journal of Cardiology: Heart & Vasculature GLP-1 RA Diabetes Stroke Meta-analysis Outcomes |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | GLP-1 RA Diabetes Stroke Meta-analysis Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2352906725000417 |
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