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Association of Periprocedural GLP-1 Receptor Agonist Therapy With 1-Year Major Adverse Cardiovascular Events After

Abdullah Ghuman1, Maumita Das1

  • 1Department of Internal Medicine, TidalHealth Peninsula Regional, Salisbury, Maryland.

Journal of the Society for Cardiovascular Angiography & Interventions
|July 28, 2026
PubMed

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) may reduce major adverse cardiovascular events (MACE) after carotid artery stenting (CAS). This study found GLP-1 RA therapy was associated with lower 1-year MACE, primarily driven by reduced mortality.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Interventional Cardiology

Background:

  • Major adverse cardiovascular events (MACE) remain a significant concern after carotid artery stenting (CAS).
  • Limited pharmacological options exist to reduce post-CAS cardiovascular risk beyond standard antiplatelet and statin therapies.
  • Glucagon-like peptide-1 receptor agonists (GLP-1 RA) have demonstrated MACE reduction in patients with type 2 diabetes and atherosclerotic cardiovascular disease, but data in CAS populations are scarce.

Purpose of the Study:

  • To investigate the association between periprocedural glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy and 1-year composite MACE in patients undergoing carotid artery stenting (CAS).

Main Methods:

  • A retrospective cohort study utilizing the TriNetX Global Collaborative Network (2015-2023).
  • Adult patients undergoing CAS were analyzed, with periprocedural GLP-1 RA exposure defined as prescription within ±12 months of the procedure.
  • Propensity score matching (1:1 nearest-neighbor) balanced 41 covariates to compare 1-year composite MACE between GLP-1 RA exposed and unexposed groups.

Main Results:

  • After propensity score matching, 899 pairs of patients were analyzed.
  • Periprocedural GLP-1 RA therapy was associated with a statistically significant reduction in 1-year composite MACE (39.7% vs. 44.6%; RR, 0.89; P = .04), an absolute risk reduction of 4.9%.
  • The reduction in composite MACE was primarily driven by a significant decrease in all-cause mortality (3.9% vs. 8.9%; RR, 0.44; P < .001), with no significant difference in myocardial or cerebral infarction rates.

Conclusions:

  • Periprocedural GLP-1 RA therapy shows a promising association with reduced 1-year MACE following CAS.
  • These findings are hypothesis-generating and suggest a potential benefit of GLP-1 RA in this patient population.
  • Prospective evaluation of GLP-1 RA therapy in carotid revascularization populations is warranted.
Abstract

Keywords:
atherosclerotic cardiovascular diseasecarotid artery stentingglucagon-like peptide-1 receptor agonistsmajor adverse cardiovascular eventsmortalitypropensity score matching

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