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September 10, 2026European Heart Journal - Cardiovascular PharmacotherapyOpen Access

Vagal activity related events and glucagon-like peptide-1 receptor agonists

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Authors

LALina Al-AnsarySNSebastian Kinnberg NielsenMJMads Hashiba Jensen

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Overview

Cohort study reveals no increased risk of vagal events in patients initiating GLP-1 receptor agonists, suggesting common side effects do not trigger serious nerve-related complications.

Key Points

  • To investigate whether initiation of glucagon-like peptide-1 receptor agonists is associated with an increased risk of vagal activity related clinical events.
  • Using nationwide Danish health registries (January 2010 to October 2022), researchers identified patients with type 2 diabetes mellitus newly initiating GLP-1 receptor agonists (N=50,076) or SGLT-2 inhibitors as active controls (N=73,138), along with cohorts treated for obesity.
  • Investigators calculated standardized 1-year absolute risks and risk ratios for vagal activity related events, defined as syncope, fractures, bradyarrhythmia, or cardiac device implantation.
  • The standardized 1-year absolute risk of syncope was 0.58% (95% CI: 0.51% to 0.66%) for GLP-1 receptor agonist users and 0.56% (95% CI: 0.50% to 0.62%) for SGLT-2 inhibitor users.
  • Standardized risk ratios comparing GLP-1 receptor agonists to SGLT-2 inhibitors were 0.90 (95% CI: 0.79 to 1.01) for fractures, 0.97 (95% CI: 0.67 to 1.28) for bradyarrhythmia, and 0.86 (95% CI: 0.62 to 1.10) for cardiac device implantation, with consistent null associations observed in obesity cohorts.

Cite This Study

Al-Ansary et al. (2026) studied this question.

synapsesocial.com/papers/6aa27ae958559d80afc73c2dhttps://doi.org/10.1093/ehjcvp/pvag072
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