Abstract Details

Title Impact of GLP-1 Receptor Agonists After Mild Stroke in Obese Patients: A Multicenter Propensity Score-matched Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-016

Objective To evaluate the effect of initiating glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy after a mild ischemic stroke on clinical outcomes in obese patients, focusing on recurrent cerebrovascular events, healthcare utilization, and survival.

Background Stroke is a leading cause of death and disability, with obesity as a major modifiable risk factor for both incidence and recurrence. Effective secondary prevention is critical. While GLP-1RAs were developed for glycemic control, they also reduce cardiovascular risk. Their specific impact on post-stroke outcomes, however, remains unclear due to limited trial data.

Design/Methods We conducted a retrospective cohort study using data from the TriNetX Research Network. Adult patients (≥18 years) with obesity and mild ischemic stroke (NIHSS 0–8) were included. Patients who initiated GLP-1RAs within one month post-stroke were compared to non-users. Propensity score matching (PSM) was applied to balance baseline characteristics. The primary outcome was recurrent stroke, with secondary outcomes including transient ischemic attack (TIA), hospital readmission, and imaging utilization within one year post-stroke.

Results A total of 246 patients who initiated GLP-1RA were compared to 30,629 non-users. After PSM, 243 patients were included in each cohort. GLP-1RA users had a significantly lower risk of recurrent stroke (39.5% vs. 52.7%, RR 0.750, 95% CI 0.617–0.912, p=0.004) and hospital readmission (20.2% vs. 30.5%, RR 0.662, 95% CI 0.484–0.907, p=0.009). They also had reduced head CT/MRI imaging utilization (13.6% vs. 20.6%, RR 0.660, 95% CI 0.442–0.987, p=0.040). No significant difference was observed in TIA incidence (6.6% vs. 7.0%, RR 0.941, 95% CI 0.487–1.819, p=0.857).

Conclusions GLP-1RA therapy following mild ischemic stroke in obese patients was associated with a lower risk of recurrent stroke, hospital readmission, and imaging use. These findings support the potential role of GLP-1RAs in secondary stroke prevention for this high-risk population. Larger prospective studies are needed to confirm these results and guide clinical recommendations.

Authors/Disclosures
Georgios Sioutas, MD PRESENTER	Dr. Sioutas has nothing to disclose.
Caitlin Rivet, RN	Ms. Rivet has nothing to disclose.

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