Stroke Vasc Interv Neurol. 2025 Sep 16;5(6):e001933. doi: 10.1161/SVIN.125.001933. eCollection 2025 Nov.
ABSTRACT
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are commonly prescribed for the management of type 2 diabetes, and recent studies have highlighted their neuroprotective and anti-inflammatory properties. However, their influence on clinical outcomes in patients undergoing endovascular treatment for unruptured intracranial aneurysms remains largely unexplored.
METHODS: This retrospective cohort study utilized the TriNetX database to identify patients with type 2 diabetes (International Classification of Diseases, Tenth Revision [ICD-10]: E11) and unruptured intracranial aneurysms (ICD-10: I67.1). Patients were categorized based on the use of GLP-1RAs. The outcomes included overall survival, poor functional outcome, new subarachnoid hemorrhage, and hydrocephalus. The propensity score matching method was applied.
RESULTS: A total of 6824 patients met the inclusion criteria, with 447 patients in each group following propensity score matching. No statistically significant differences were observed in short- and mid-term mortality between GLP-1RAs users and non-users. However, long-term mortality was significantly lower in the GLP-1 group (odds ratio 0.58, 95% CI 0.36-0.94). Furthermore, GLP-1RAs users demonstrated significantly reduced risks of poor functional outcomes (odds ratio 0.37, 95% CI 0.21-0.66), new subarachnoid hemorrhage (odds ratio 0.39, 95% CI 0.27-0.56), and hydrocephalus (odds ratio 0.57, 95% CI 0.33-0.97) at 3 months, with similar trends persisting in mid- and long-term follow-up.
CONCLUSION: Use of GLP-1RAs in patients with unruptured intracranial aneurysms treated via endovascular intervention is associated with improved long-term survival and reduced risks of subarachnoid hemorrhage, hydrocephalus, and poor functional outcomes. These findings suggest a potential therapeutic benefit beyond glycemic control. Prospective studies are needed to validate these results and explore their implications for clinical decision-making in aneurysm treatment.
PMID:41608727 | PMC:PMC12697656 | DOI:10.1161/SVIN.125.001933
