Erik Swain , 2025-05-16 14:07:00
Key takeaways:
- Among patients with diabetes, those taking a GLP-1 had better 3-year survival rates after PCI for a heart attack vs. nonusers.
- GLP-1 use made no difference in in-stent restenosis or revascularization rates.
Among patients with diabetes who underwent PCI after an acute heart attack, those taking a GLP-1 had better survival rates than those not taking one, researchers reported.
“Our team undertook this study because there is limited data regarding the impact of GLP-1 receptor agonists on outcomes following PCI in patients with type 2 diabetes,” Moses Sghayyer, MD, an internal medicine resident at the University of Alabama at Birmingham, who presented the findings at the Society for Cardiovascular Angiography and Interventions Scientific Sessions, told Healio. “Previous studies have demonstrated that GLP-1s reduce the risk of major adverse cardiovascular events in patients with type 2 diabetes, but their specific role in postinfarction treatment after PCI remains unclear. We aimed to analyze whether GLP-1 use in this context would reduce all-cause mortality, given the existing cardiovascular benefits of these medications. We also aimed to investigate the impact of GLP-1 on in-stent restenosis and revascularization rates, as this area remains underexplored.”
Sghayyer and colleagues used the TriNetX electronic health record platform to identify patients with type 2 diabetes who underwent PCI for acute MI between 2015 and 2022. After propensity score matching based on demographics, comorbidities and medications, the researchers compared 776 patients who used a GLP-1 after their procedure with 776 patients who did not (mean age, 64 years; 57% men). Approximately two-thirds of patients in both groups also had obesity. The results were simultaneously published in the Journal of the Society for Cardiovascular Angiography & Interventions.
The primary outcome of all-cause mortality at 3 years was lower in the GLP-1 group (HR = 0.74; 95% CI, 0.6-0.92), according to the researchers.
There was no difference between the groups in the secondary outcomes of in-stent restenosis (HR = 1.28; 95% CI, 0.88-1.86) and revascularization (HR = 1.21; 95% CI, 0.91-1.6) at 3 years, the researchers found.
“The difference in mortality without a corresponding decrease in revascularization or in-stent restenosis suggests that the observed mortality benefit may be attributable to the broader cardiovascular protective effects of GLP-1s rather than a direct influence on PCI-specific outcomes,” Sghayyer told Healio. “GLP-1s have demonstrated anti-inflammatory, anti-atherosclerotic and cardioprotective properties, which could explain the mortality reduction independently of procedural outcomes.”
The results need to be confirmed by prospective, randomized trials and further explained by mechanistic studies, he said, noting that a retrospective study can show correlation but not causation.
“Physicians should consider the potential mortality benefits of GLP-1s when managing patients with type 2 diabetes after PCI for acute myocardial infarction,” Sghayyer told Healio. “While GLP-1s may not reduce revascularization or in-stent restenosis, they could provide long-term survival benefits, reinforcing their use as part of comprehensive postinfarction care in diabetic patients. Further studies are needed to validate these findings and establish clear guidelines.”
Reference:
For more information:
Moses Sghayyer, MD, can be reached at Mrsghayyer@uabmc.edu.
Sources/Disclosures
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Sghayyer M, et al. Abstract OR3-2. Presented at: Society for Cardiovascular Angiography and Interventions Scientific Sessions; May 1-3, 2025; Washington, D.C.
Disclosures:
The authors report no relevant financial disclosures.
