GLPwatch
Risk of major adverse cardiovascular events and stroke associated with treatment with GLP-1 or the dual GIP/GLP-1 receptor agonist tirzepatide for type 2 diabetes: A systematic review and meta-analysis.
Eur Stroke J · 2024
Last updated 2026-05-28A review of 13 clinical trials involving 65,878 people with type 2 diabetes found that GLP-1 drugs or the dual GIP/GLP-1 drug tirzepatide lowered the risk of major heart problems by 13% and reduced all-cause death by 12% compared to a placebo. GLP-1 drugs also cut the risk of stroke by 16% and nonfatal stroke by 15%, with the strongest effect seen for ischemic stroke, but did not clearly affect fatal strokes or heart attacks.
AI summary of the abstract below.
| Journal | Eur Stroke J, 2024 |
|---|---|
| Citations | 44 |
| Relative citation ratio | 8.43 |
| NIH percentile | 97 |
| Molecules | tirzepatide |
| Conditions studied | Type 2 Diabetes, Cardiovascular Risk Reduction |
Abstract
INTRODUCTION: Mounting evidence suggests that glucagon-like-peptide-1 receptor-agonists (GLP-1 RAs) attenuate cardiovascular-risk in type-2 diabetes (T2DM). Tirzepatide is the first-in-class, dual glucose-dependent-insulinotropic-polypeptide GIP/GLP-1 RA approved for T2DM.
PATIENTS AND METHODS: A systematic review and meta-analysis of randomized-controlled clinical trials (RCTs) was performed to estimate: (i) the incidence of major adverse cardiovascular events (MACE); and (ii) incidence of stroke, fatal, and nonfatal stroke in T2DM-patients treated with GLP-1 or GIP/GLP-1 RAs (vs placebo).
RESULTS: Thirteen RCTs (9 and 4 on GLP-1 RAs and tirzepatide, respectively) comprising 65,878 T2DM patients were included. Compared to placebo, GLP-1RAs or GIP/GLP-1 RAs reduced MACE (OR: 0.87; 95% CI: 0.81-0.94; < 0.01; = 37%), all-cause mortality (OR: 0.88; 95% CI: 0.82-0.96; < 0.01; = 21%) and cardiovascular-mortality (OR: 0.88; 95% CI: 0.80-0.96; < 0.01; = 14%), without differences between GLP-1 versus GIP/GLP-1 RAs. Additionally, GLP-1 RAs reduced the odds of stroke (OR: 0.84; 95% CI: 0.76-0.93; < 0.01; = 0%) and nonfatal stroke (OR: 0.85; 95% CI: 0.76-0.94; < 0.01; = 0%), whereas no association between fatal stroke and GLP-1RAs was uncovered (OR: 0.80; 95% CI: 0.61-1.05; = 0.105; = 0%). In secondary analyses, GLP-1 RAs prevented ischemic stroke (OR: 0.74; 95% CI: 0.61-0.91; < 0.01; = 0%) and MACE-recurrence, but not hemorrhagic stroke (OR: 0.92; 95% CI: 0.51-1.66; = 0.792; = 0%). There was no association between GLP-1RAs or GIP/GLP-1 RAs and fatal or nonfatal myocardial infarction.
DISCUSSION AND CONCLUSION: GLP-1 and GIP/GLP-1 RAs reduce cardiovascular-risk and mortality in T2DM. While there is solid evidence that GLP-1 RAs significantly attenuate the risk of ischemic stroke in T2DM, dedicated RCTs are needed to evaluate the efficacy of novel GIP/GLP-1 RAs for primary and secondary stroke prevention.
Verbatim abstract via PubMed 38400569 ↗
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