Key result
GLP-1 receptor agonists show potential cardioprotective benefits post-STEMI, but broader clinical evidence remains mixed.
Why the study?
Current evidence on glucagon-like peptide-1 receptor agonist use after STEMI is limited and requires synthesis to clarify their potential as adjunctive therapy.
Does GLP-1RA therapy improve imaging, clinical, and safety outcomes in adults following STEMI?
Does GLP-1RA therapy improve imaging, clinical, and safety outcomes in adults following STEMI?
GLP-1RAs show promise for cardioprotection and improving surrogate outcomes like infarct size and myocardial salvage post-STEMI, though evidence for reducing hard clinical events is currently lacking.
Purpose of review: This scoping review synthesizes current evidence on glucagon-like peptide-1 receptor agonist (GLP-1RA) use after ST-elevation myocardial infarction (STEMI), highlighting their potential as adjunctive therapy. Recent findings: Ten studies investigated exenatide and liraglutide in adults with STEMI, evaluating imaging, clinical, mechanistic, and safety outcomes. GLP-1RA use was safe and well tolerated. Exenatide demonstrated improvements in infarct size, myocardial salvage, and cardiac function, although two trials in broader STEMI populations reported no post-infarction improvements. Across three trials, liraglutide was associated with improved myocardial salvage, infarct size, left ventricular ejection fraction, stroke volume and no-reflow, supported by favorable biomarker changes, but without significant reductions in major cardiovascular events. Summary: While most existing evidence is based on studies with limited generalizability, GLP-1RA use shows promise in improving post-STEMI outcomes. The consistent benefits reported support the need for larger, multicenter trials to clarify GLP-1RA role in cardioprotection and long-term outcomes.
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Soares et al. (2025) conducted a review in ST-elevation myocardial infarction (STEMI). Glucagon-like peptide-1 receptor agonists (GLP-1RA) vs. Placebo or standard care was evaluated on Cardioprotective effects including infarct size, myocardial salvage, left ventricular function, and major adverse cardiovascular events. GLP-1 receptor agonists demonstrated safety and potential cardioprotective benefits, including improvements in myocardial salvage, infarct size, and ventricular function following STEMI, although results across broader populations were mixed.
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