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Association between glucagon-like peptide-1 receptor agonist use and ischemic stroke severity
Huanwen Chen1, Dhairya A Lakhani2, Sridhara S Yaddanapudi3
1Department of Neurosurgery, University of Maryland Medical Center, Baltimore, MD, USA; Department of Neurology, University of Maryland Medical Center, Baltimore, MD, USA.
Journal of the Neurological Sciences
|July 23, 2026
Summary
Pre-stroke use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) was linked to less severe acute ischemic strokes (AIS). GLP-1RA users experienced reduced stroke severity, fewer complications, and lower mortality rates.
Area of Science:
- Neurology
- Cardiology
- Endocrinology
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are known to decrease stroke incidence.
- However, their effect on the severity of acute ischemic stroke (AIS) is not well understood.
Purpose of the Study:
- To investigate the association between pre-stroke GLP-1RA use and the severity of AIS.
- To evaluate the impact of GLP-1RA on post-stroke outcomes.
Main Methods:
- A retrospective cohort study utilized data from the TriNetX US Collaborative Network (2016-2024).
- Patients were classified by GLP-1RA use for at least six months before stroke.
- Propensity score matching was employed to compare outcomes, including the National Institutes of Health Stroke Scale (NIHSS) score.
Main Results:
- The study included 209,180 first-time AIS patients, with 4,773 (2.3%) using GLP-1RAs.
- After propensity score matching, GLP-1RA users showed a significantly lower median NIHSS (3 vs. 4).
- GLP-1RA users had reduced rates of severe stroke, dysphagia/dysarthria, aphasia, hemiplegia/hemiparesis, intracranial hemorrhage, and 30-day mortality.
Conclusions:
- Pre-stroke GLP-1RA use is associated with decreased severity in first-time AIS.
- GLP-1RA users experienced fewer neurological symptoms, complications, and lower mortality.
- The benefits of GLP-1RAs may extend to mitigating the impact of cerebrovascular events.
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