Publication details
GLP-1 receptor agonists for secondary prevention after myocardial infarction and stroke in type 2 diabetes: nationwide real-world evidence
| Authors | |
|---|---|
| Year of publication | 2026 |
| Type | Peer-reviewed scientific article |
| Magazine / Source | EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY |
| MU Faculty or unit | |
| Citation | |
| web | https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwag002/8416617 |
| Doi | https://doi.org/10.1093/eurjpc/zwag002 |
| Keywords | Glucagon-like peptide-1 receptor agonists (GLP-1 RA); Type 2 diabetes; Myocardial infarction; Stroke; Major adverse cardiovascular events (MACE); Health disparities |
| Description | Aims Glucagon-like peptide-1 receptor agonists (GLP-1RA) reduce cardiovascular risk in patients with Type 2 diabetes (T2D) and established atherosclerotic cardiovascular disease and are recommended in guidelines. We evaluated the real-world effectiveness of GLP-1RA therapy on cardiovascular outcomes in patients with T2D after myocardial infarction (MI) or ischaemic stroke and examined trends and disparities. Methods and results Using nationwide Czech registry data (2015-24), we identified patients with incident nonfatal MI or ischaemic stroke and confirmed T2D. GLP-1RA users-initiating therapy within 12 months post-event-were propensity score matched to non-users. The primary outcome was major adverse cardiovascular events (MACE: nonfatal MI, nonfatal stroke, cardiovascular death); secondary outcomes included individual components and all-cause mortality. GLP-1RA therapy was initiated in only similar to 2% of MI and stroke survivors with T2D. Among 126 845 MI survivors, 28 206 had T2D; the matched cohort comprised 2271 patients (401 GLP-1RA; median follow-up 35 months). GLP-1RA use was associated with lower risk of MACE (HR 0.7; 95% CI, 0.52-0.93), all-cause (HR 0.61; 95% CI, 0.47-0.80), and cardiovascular death (HR 0.54; 95% CI, 0.36-0.80). Among 177 115 stroke survivors, 73 750 had T2D; the matched cohort comprised 2235 patients (385 GLP-1RA; median follow-up 27 months). GLP-1RA use was associated with lower risk of MACE (HR 0.71; 95% CI, 0.54-0.94), all-cause (HR 0.59; 95% CI, 0.46-0.76), and cardiovascular death (HR 0.55; 95% CI, 0.37-0.81). Conclusion GLP-1RA therapy after MI or stroke in T2D was associated with substantially lower risks of MACE, cardiovascular, and all-cause death in real-world practice. Utilization remained low, particularly among women and older adults, underscoring the need for broader and more equitable implementation in secondary prevention. |
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