The Role of Glucagon-Like Peptide-1 Receptor Agonists in Post ST-Segment Elevation Myocardial Infarction Care: A Scoping Review.

PURPOSE OF REVIEW: This scoping review synthesizes current evidence on glucagon-like peptide-1 receptor agonist (GLP-1RA) use after ST-elevation myocardial infarction (STEMI), highlighting their potential as adjunctive therapy. RECENT FINDINGS: Ten studies investigated exenatide and liraglutide in adults with STEMI, evaluating imaging, clinical, mechanistic, and safety outcomes. GLP-1RA use was safe and well tolerated. Exenatide demonstrated improvements in infarct size, myocardial salvage, and cardiac function, although two trials in broader STEMI populations reported no post-infarction improvements. Across three trials, liraglutide was associated with improved myocardial salvage, infarct size, left ventricular ejection fraction, stroke volume and no-reflow, supported by favorable biomarker changes, but without significant reductions in major cardiovascular events. SUMMARY: While most existing evidence is based on studies with limited generalizability, GLP-1RA use shows promise in improving post-STEMI outcomes. The consistent benefits reported support the need for larger, multicenter trials to clarify GLP-1RA role in cardioprotection and long-term outcomes.