GLP-1 receptor agonists for secondary prevention after
myocardial infarction and stroke in type 2 diabetes: nationwide
real-world evidence

J 2026

GLP-1 receptor agonists for secondary prevention after myocardial infarction and stroke in type 2 diabetes: nationwide real-world evidence

ŠEDOVÁ, Petra; Michal VRABLIK; Petr KALA; Petr OSTADAL; Ales TICHOPAD et al.

Základní údaje

Originální název

GLP-1 receptor agonists for secondary prevention after myocardial infarction and stroke in type 2 diabetes: nationwide real-world evidence

Autoři

Vydání

EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, OXFORD, OXFORD UNIV PRESS, 2026, 2047-4873

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 7.500 v roce 2024

Označené pro přenos do RIV

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Glucagon-like peptide-1 receptor agonists (GLP-1 RA); Type 2 diabetes; Myocardial infarction; Stroke; Major adverse cardiovascular events (MACE); Health disparities

Štítky

14110127, 14110211, 14119612

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 7. 4. 2026 14:40, Mgr. Tereza Miškechová

Anotace

V originále

Aims Glucagon-like peptide-1 receptor agonists (GLP-1RA) reduce cardiovascular risk in patients with Type 2 diabetes (T2D) and established atherosclerotic cardiovascular disease and are recommended in guidelines. We evaluated the real-world effectiveness of GLP-1RA therapy on cardiovascular outcomes in patients with T2D after myocardial infarction (MI) or ischaemic stroke and examined trends and disparities. Methods and results Using nationwide Czech registry data (2015-24), we identified patients with incident nonfatal MI or ischaemic stroke and confirmed T2D. GLP-1RA users-initiating therapy within 12 months post-event-were propensity score matched to non-users. The primary outcome was major adverse cardiovascular events (MACE: nonfatal MI, nonfatal stroke, cardiovascular death); secondary outcomes included individual components and all-cause mortality. GLP-1RA therapy was initiated in only similar to 2% of MI and stroke survivors with T2D. Among 126 845 MI survivors, 28 206 had T2D; the matched cohort comprised 2271 patients (401 GLP-1RA; median follow-up 35 months). GLP-1RA use was associated with lower risk of MACE (HR 0.7; 95% CI, 0.52-0.93), all-cause (HR 0.61; 95% CI, 0.47-0.80), and cardiovascular death (HR 0.54; 95% CI, 0.36-0.80). Among 177 115 stroke survivors, 73 750 had T2D; the matched cohort comprised 2235 patients (385 GLP-1RA; median follow-up 27 months). GLP-1RA use was associated with lower risk of MACE (HR 0.71; 95% CI, 0.54-0.94), all-cause (HR 0.59; 95% CI, 0.46-0.76), and cardiovascular death (HR 0.55; 95% CI, 0.37-0.81). Conclusion GLP-1RA therapy after MI or stroke in T2D was associated with substantially lower risks of MACE, cardiovascular, and all-cause death in real-world practice. Utilization remained low, particularly among women and older adults, underscoring the need for broader and more equitable implementation in secondary prevention.

Návaznosti

NW24-09-00215, projekt VaV

Název: Analýza velkých dat pro záchranu životů pacientů s akutním infarktem myokardu a cévní mozkovou příhodou v České republice (MISA-BID Myocardial Infarction and Stroke Big Data Analysis)

Investor: Ministerstvo zdravotnictví ČR, Analýza velkých dat pro záchranu životů pacientů s akutním infarktem myokardu a cévní mozkovou příhodou v České republice (MISA-BID Myocardial Infarction and Stroke Big Data Analysis), Podprogram 1 - standardní

Citovat

ŠEDOVÁ, Petra; Michal VRABLIK; Petr KALA; Petr OSTADAL; Ales TICHOPAD; Ales TOMEK; Robert MIKULÍK; Gleb DONIN; Simona LITTNEROVÁ; Julia Anna KENT; Jiří JARKOVSKÝ; Virend K SOMERS a Robert D BROWN JR. GLP-1 receptor agonists for secondary prevention after myocardial infarction and stroke in type 2 diabetes: nationwide real-world evidence. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. OXFORD: OXFORD UNIV PRESS, 2026, 13 s. ISSN 2047-4873. Dostupné z: https://doi.org/10.1093/eurjpc/zwag002.

@article{2565367,
   author = {Šedová, Petra and Vrablik, Michal and Kala, Petr and Ostadal, Petr and Tichopad, Ales and Tomek, Ales and Mikulík, Robert and Donin, Gleb and Littnerová, Simona and Kent, Julia Anna and Jarkovský, Jiří and Somers, Virend K and Brown Jr, Robert D},
   article_location = {OXFORD},
   doi = {https://doi.org/10.1093/eurjpc/zwag002},
   keywords = {Glucagon-like peptide-1 receptor agonists (GLP-1 RA); Type 2 diabetes; Myocardial infarction; Stroke; Major adverse cardiovascular events (MACE); Health disparities},
   language = {eng},
   issn = {2047-4873},
   journal = {EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY},
   title = {GLP-1 receptor agonists for secondary prevention after myocardial infarction and stroke in type 2 diabetes: nationwide real-world evidence},
   url = {https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwag002/8416617},
   year = {2026}
}

TY  - JOUR
ID  - 2565367
AU  - Šedová, Petra - Vrablik, Michal - Kala, Petr - Ostadal, Petr - Tichopad, Ales - Tomek, Ales - Mikulík, Robert - Donin, Gleb - Littnerová, Simona - Kent, Julia Anna - Jarkovský, Jiří - Somers, Virend K - Brown Jr, Robert D
PY  - 2026
TI  - GLP-1 receptor agonists for secondary prevention after myocardial infarction and stroke in type 2 diabetes: nationwide real-world evidence
JF  - EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
PB  - OXFORD UNIV PRESS
SN  - 20474873
KW  - Glucagon-like peptide-1 receptor agonists (GLP-1 RA)
KW  - Type 2 diabetes
KW  - Myocardial infarction
KW  - Stroke
KW  - Major adverse cardiovascular events (MACE)
KW  - Health disparities
UR  - https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwag002/8416617
N2  - Aims Glucagon-like peptide-1 receptor agonists (GLP-1RA) reduce cardiovascular risk in patients with Type 2 diabetes (T2D) and established atherosclerotic cardiovascular disease and are recommended in guidelines. We evaluated the real-world effectiveness of GLP-1RA therapy on cardiovascular outcomes in patients with T2D after myocardial infarction (MI) or ischaemic stroke and examined trends and disparities. Methods and results Using nationwide Czech registry data (2015-24), we identified patients with incident nonfatal MI or ischaemic stroke and confirmed T2D. GLP-1RA users-initiating therapy within 12 months post-event-were propensity score matched to non-users. The primary outcome was major adverse cardiovascular events (MACE: nonfatal MI, nonfatal stroke, cardiovascular death); secondary outcomes included individual components and all-cause mortality. GLP-1RA therapy was initiated in only similar to 2% of MI and stroke survivors with T2D. Among 126 845 MI survivors, 28 206 had T2D; the matched cohort comprised 2271 patients (401 GLP-1RA; median follow-up 35 months). GLP-1RA use was associated with lower risk of MACE (HR 0.7; 95% CI, 0.52-0.93), all-cause (HR 0.61; 95% CI, 0.47-0.80), and cardiovascular death (HR 0.54; 95% CI, 0.36-0.80). Among 177 115 stroke survivors, 73 750 had T2D; the matched cohort comprised 2235 patients (385 GLP-1RA; median follow-up 27 months). GLP-1RA use was associated with lower risk of MACE (HR 0.71; 95% CI, 0.54-0.94), all-cause (HR 0.59; 95% CI, 0.46-0.76), and cardiovascular death (HR 0.55; 95% CI, 0.37-0.81). Conclusion GLP-1RA therapy after MI or stroke in T2D was associated with substantially lower risks of MACE, cardiovascular, and all-cause death in real-world practice. Utilization remained low, particularly among women and older adults, underscoring the need for broader and more equitable implementation in secondary prevention.
ER  -

ŠEDOVÁ, Petra; Michal VRABLIK; Petr KALA; Petr OSTADAL; Ales TICHOPAD; Ales TOMEK; Robert MIKULÍK; Gleb DONIN; Simona LITTNEROVÁ; Julia Anna KENT; Jiří JARKOVSKÝ; Virend K SOMERS a Robert D BROWN JR. GLP-1 receptor agonists for secondary prevention after myocardial infarction and stroke in type 2 diabetes: nationwide real-world evidence. \textit{EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY}. OXFORD: OXFORD UNIV PRESS, 2026, 13 s. ISSN~2047-4873. Dostupné z: https://doi.org/10.1093/eurjpc/zwag002.

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