Among Stroke Survivors, GLP-1RAs, SGLT2is May Reduce Risk of Future MI, Recurrent Stroke

A new analysis of more than 7000 stroke survivors (mean age 72 years) found that the risk of subsequent stroke, myocardial infarction (MI), or death was lower among those taking either a sodium glucose contransporter-2 inhibitor (SGLT2i) or a glucagon-like peptide-1 receptor agonist (GLP-1RA) comparted to those not receiving a medication from either class over a 3-year follow-up period.

M Ali Sheffeh, MD
Lead Author
Courtesy of AHA

Specifically, study authors reported a 74% lower risk of death and an 84% lower risk of MI among participants taking either a GLP-1RA or an SGLT2i. Among those taking an SGLT2i, there was a 67% reduced risk of recurrent stroke. The diminished risk remained after multivariable adjustment for age, sex, smoking status, hypertension and diabetes status, lipid disorder, kidney disease, and history of either MI or heart failure.

The study findings are being presented at the American Heart Association’s (AHA) Scientific Sessions 2024, November 16-18, 2024, in Chicago.

“Unfortunately, a quarter of people who survive a stroke will have another stroke, and they are also at risk for other cardiovascular events such as a heart attack since many of the risk factors of a stroke are also associated with other forms of heart disease,” lead study author M Ali Sheffeh, MD, an internal medicine physician and research scholar at the Mayo Clinic in Rochester, Minnesota said in an AHA press release. “Managing these risks, as well as looking at novel approaches to help lower the chances of another stroke, heart attack or death among this population are all critical steps in increasing stroke survival and improving the quality of life for people who have had a stroke.”

Sheffeh and colleagues tapped health data for 7044 adults admitted to a hospital for acute ischemic stroke between January 2000 and June 2022 in the Rochester Epidemiology Project, a databased collaboration among medical facilities in the Mayo Clinic health systems in Minnesota and Wisconsin. Participants were an average age of 72 years; 52% of the cohort were men; 94% self-identified as White, 1.5% as Black, adults, 1.5% as Asian adults and 3% identified as adults of “other” race. 

Across the 3-year study period, the mortality rate among stroke survivors who took either a GLP-1RA or an SGLT2i was 11.8%, compared to 54% among patients who did not take either class of medication. The MI rate among adults receiving either medication was also 1.5%, compared to 6.1% among patients not taking a medication in either class. The rate of recurrent stroke was similar between patients who did and did not receive either medication, at approximately 6%.

“When comparing multiple variables, we can still conclude that treatment with either medication was associated with lower risk of recurrent stroke even though the rate was similar between patients who did and did not receive either medication,” Sheffeh said. “The results of the study are consistent with other research about the preventive role of these medications against cardiovascular disease in people with obesity or heart failure.”

In a subanalysis of study participants who had taken either class of medication for at least 6 months, Sheffeh et al found results similar to those in the primary study.

References

GLP-1, SGLT2 medications may lower stroke survivor’s risk of future heart attack, stroke. News release. American Heart Association. November 11, 2024. Accessed November 11, 2024.