A retrospective analysis of 7,044 stroke survivors found that patients treated with glucagon-like peptide-1 receptor agonists or sodium-glucose cotransporter 2 inhibitors had lower rates of subsequent cardiovascular events and mortality compared with untreated patients over a 3-year follow-up period, according to research presented at the American Heart Association's Scientific Sessions 2024.
In the analysis, investigators showed a 74% lower mortality risk and an 84% lower myocardial infarction risk among patients receiving either medication class. Sodium-glucose cotransporter 2 (SGLT2) inhibitor therapy was associated with a 67% lower recurrent stroke risk in multivariate analysis.
The mortality rates between cohorts were 11.8% for the treatment group and 54% for the nontreatment group. Myocardial infarction rates were 1.5% for the treatment group and 6.1% for the nontreatment group. Recurrent stroke rates were approximately 6% in both groups before multivariate adjustment.
The Rochester Epidemiology Project database provided medical records for analysis, examining outcomes for ischemic stroke patients admitted between January 2000 and June 2022. The study population included patients with a mean age of 72 years with 52% being male and 48% female. White patients made up 94% of the study population. Type 2 diabetes prevalence among treated patients was 93%.
The analysis adjusted for age, sex, smoking status, hypertension, type 2 diabetes, peripheral artery disease, hyperlipidemia, chronic kidney disease, prior myocardial infarction, and heart failure history.
A sub analysis of patients who took the medications for 6 months or more yielded similar results to the primary analysis regarding cardiovascular events and mortality.
The investigators identified several limitations of the study. Data came from a single health system. The patient population was predominantly White. Geographic representation was limited. Stroke burden assessment was not available, and medication indication data was incomplete.
Ischemic stroke, which accounted for approximately 85% of all strokes, led to recurrent strokes in 25% of survivors, and was a leading cause of disability.
Note: This research was presented as an abstract at the American Heart Association's Scientific Sessions 2024 and has not yet been published in a peer-reviewed journal.