GLP-1 Receptor Agonists Reduce Adverse Cardiovascular Outcomes, Improve Survival

Patients had improved outcomes after ST-elevation myocardial infarction (STEMI) and when living with coronary plaque when using glucagon-like peptide-1 (GLP-1) receptor agonists according to posters presented during the ASPC 2025 Congress on CVD Prevention, held in Boston from August 1 to August 3, 2025.1,2 These results encourage the use of GLP-1s in this area, improving survival for patients living with these conditions.

GLP-1s are beneficial to both cardiovascular outcomes and survival | Image credit: Patrick Bay Damsted - stock.adobe.com

GLP-1s have shown their use in type 2 diabetes primarily, capable of lowering the blood sugar of those who use the medication as prescribed.3 These medications have also shown use in treating obesity. Although there have been some studies that have shown potential benefit of using GLP-1s in cardiovascular disease, the extent of their benefit in patients with coronary plaque and in patients following acute ST-elevation myocardial infarction (STEMI) is unknown.

The effectiveness of GLP-1 therapy in patients with coronary plaque was the primary objective of a poster presented during the conference.1 There were 2 propensity-matched cohorts with documented cases of coronary plaque who were identified using the TriNetX electronic medical record network between January 1, 2022, and December 31, 2024. The 2 groups corresponded to those who had received GLP-1s and those who had not. Patients were included if they had imaging that was consistent with plaque and had a diagnostic code for atherosclerosis.

Lipid panel, inpatient hospitalizations, hemoglobin A1C levels, major adverse cardiovascular events, and myocardial infarction were all primary outcomes measured in the study.

Patients who used GLP-1s had a lower risk of major adverse cardiovascular events (34.3% vs 41.9%; OR, 0.725; 95% CI, 0.699-0.751), myocardial infarction (13.9% vs 20.8%; OR, 0.615; 95% CI, 0.586-0.644), and inpatient visits (22.8% vs 28.7%; OR, 0.731; 95% CI, 0.702-0.761) compared with those who had not used GLP-1s.

Those who had used GLP-1s had higher 1-year event-free survival and improved lipid profiles. Those who used GLP-1s had higher triglycerides but had more improvement in levels compared with those who did not use GLP-1s.

The researchers concluded that adverse cardiovascular outcomes were associated with the use of GLP-1s, including those in high-risk atherosclerotic populations.

GLP-1s are also beneficial when used in those with acute STEMI compared with not using the treatment.2 The second study also used the TriNetX Research Network to collect cohort data collected between January 1, 2022, and December 31, 2024. All patients were separated into 2 groups, where 1 group had taken GLP-1s and the other had not. Major adverse cardiovascular events, myocardial infarction, lipid profile differences, and inpatient hospitalizations were all primary outcomes of this study.

Higher 1-year event-free survival was found in those who had received GLP-1s, and lipid panels showed lower LDL and total cholesterol. The GLP-1 group did have higher triglycerides compared with those who had not received GLP-1s. Glycemic control was improved in those who had been treated with GLP-1s.

Hospital readmission rates over 30 days were lower in those who had taken GLP-1s (9.3% vs 12.7%; OR, 0.70; 95% CI, 0.65-0.76). Major adverse cardiovascular events (57.2% vs 66.7%; OR, 0.668; 95% CI, 0.628-0.711), recurrent myocardial infarctions (41.2% vs 53.2%; OR, 0.617; 95% CI, 0.581-0.655), and inpatient admissions (31.7% vs 39.4%; OR, 0.716; 95% CI, 0.672-0.762) were all lower in those who had taken GLP-1s compared with those who had not.

The researchers concluded that GLP-1s were beneficial when used in those with acute STEMI, improving outcomes and survival in the cohort who had utilized the treatment. Across both studies, GLP-1 shows promise when used in those with cardiovascular conditions, demonstrating a new avenue of treatment that could have major implications on future treatment of these conditions.

References

1. Yousafzai O, Annie F, Rinehart S. GLP-1 receptor agonists and cardiovascular outcomes in patients with coronary outcomes in patients with coronary plaque: a real-world propensity-matched analysis. Presented at ASPC 2025 Congress on CVD Prevention; August 1-3, 2025; Boston, MA. Poster 211

2. Yousafzai O, Annie F, Rinehart S. GLP-1 receptor agonists and cardiovascular outcomes following STEMI: a propensity-matched cohort study. Presented at ASPC Congress on CVD Prevention; August 1-3, 2025; Boston, MA. Poster 271

3. GLP-1 agonists. Cleveland Clinic. Updated July 3, 2023. Accessed August 1, 2025. https://my.clevelandclinic.org/health/treatments/13901-glp-1-agonists