Related Experiment Video
Updated: Jun 1, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
GLP-1 receptor agonists and post-endovascular thrombectomy outcomes in acute ischemic stroke: a multicenter
Pranjal Rai1, Girish Bathla1, Niharika Praveen1
1Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Insights
Glucagon-like peptide-1 receptor agonists (GLP-1As) may improve outcomes for acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy (EVT). GLP-1A use was linked to reduced mortality and hospitalizations in this high-risk group.
Area of Science:
- Neurology
- Cardiology
- Metabolic Diseases
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1As) show cardiovascular and cerebrovascular benefits in high-risk groups.
- The impact of GLP-1As on acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy (EVT) is not well-established.
Purpose of the Study:
- To investigate the association between GLP-1A exposure and outcomes in AIS patients treated with EVT.
- To evaluate the effect of GLP-1As on mortality and hospitalizations in this specific patient population.
Main Methods:
- Retrospective cohort analysis of adults (≥18 years) with AIS treated with EVT (Jan 2016 - Dec 2025) from the TriNetX Network.
- Patients exposed to GLP-1As within three months prior to EVT were compared to unexposed patients.
- Propensity score matching was used to balance demographic, comorbidity, medication, and metabolic variables, including NIH Stroke Scale, HbA1c, and BMI.
Main Results:
- 261 matched pairs of GLP-1A-exposed and unexposed patients were analyzed.
- GLP-1A use was associated with significantly lower all-cause mortality (11.5% vs 29.9%, HR 0.334) and fewer inpatient hospitalizations (39.8% vs 54.8%, HR 0.514).
- All results were statistically significant (p < 0.001).
Conclusions:
- GLP-1A exposure prior to EVT in AIS patients is associated with improved survival.
- GLP-1A use was also linked to a reduction in inpatient hospitalizations within three years post-EVT.
Background:
Glucagon-like peptide-1 receptor agonists (GLP-1As) have demonstrated cardiovascular and cerebrovascular benefits in high-risk populations, but their impact in patients with acute ischemic stroke (AIS) requiring endovascular thrombectomy (EVT) remains uncertain.
Methods:
We performed a retrospective cohort analysis using the TriNetX Network, identifying adults (≥18 years) with AIS treated with EVT from January 1, 2016 through December 31, 2025. Patients with GLP-1A exposure within three months prior to EVT constituted the exposure cohort; those without served as comparators. This pre-index window was specified to eliminate immortal time bias, with follow-up beginning on the EVT date for both cohorts. Three-year outcomes included all-cause mortality and inpatient hospitalizations. One-to-one propensity score matching was applied using demographic, comorbidity, medication, and metabolic variables including individual National Institute of Health Stroke Scale scores, Hemoglobin A1c, and body mass index.
Results:
Among 286 GLP-1A-exposed and 19,263 unexposed EVT-treated patients, 261 matched pairs were analyzed. GLP-1A use was associated with lower all-cause mortality (11.5% vs 29.9%; HR 0.334, 95% CI 0.219-0.508) and fewer inpatient hospitalizations (39.8% vs 54.8%; HR 0.514, 95% CI 0.398-0.663), both p < 0.001.
Conclusions:
Among EVT-treated AIS patients, GLP-1A exposure within three months prior to EVT was associated with improved survival and reduced inpatient hospitalizations.
Related Concept Videos
01:15Ischemic Stroke ll: Pathophysiology
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...