AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Cardiometabolic Therapy After PCI: Real-World Outcomes Associated with GLP-1 Receptor Agonist Use
By Agarwal H
Background: Patients undergoing percutaneous coronary intervention (PCI) remain at substantial risk for recurrent ischemic events despite advances in contemporary secondary prevention. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated cardiovascular benefits in patients with cardiometabolic disease; however, their impact on long-term outcomes following PCI remains incompletely characterized. Objective: To evaluate the association between GLP-1RA therapy and cardiovascular outcomes among patients with prior PCI. Methods: We conducted a retrospective propensity score-matched cohort study using Global Collaborative Network. Adults with a history of PCI were stratified by GLP-1RA exposure and matched 1:1 across 73 demographic, comorbidity, medication, procedural, and laboratory variables. Outcomes were assessed over 730 days and included major adverse cardiovascular events (MACE), non-fatal myocardial infarction (MI), stroke, repeat revascularization, heart failure (HF) hospitalization, atrial arrhythmias, in-stent restenosis, in-stent thrombosis, and all-cause hospitalization/emergency department (ED) utilization. Results: Following propensity matching, 72,955 patients were included in each cohort. GLP-1RA therapy was associated with significantly lower risks of MACE (23.7% vs 31.1%; RR 0.76, OR 0.69, p<0.001), non-fatal MI (18.3% vs 25.0%; RR 0.73, OR 0.67, p<0.001), stroke (7.8% vs 9.4%; RR 0.82, OR 0.81, p<0.001), repeat revascularization (1.0% vs 1.5%; RR 0.68, OR 0.68, p<0.001), HF hospitalization (30.7% vs 39.5%; RR 0.78, OR 0.68, p<0.001), new-onset atrial fibrillation (15.6% vs 17.0%; RR 0.92, OR 0.90, p<0.001), atrial tachyarrhythmia recurrence (17.4% vs 20.8%; RR 0.84, OR 0.81, p<0.001), and all-cause hospitalization/ED visits (58.1% vs 71.2%; RR 0.82, OR 0.56, p<0.001). No significant differences were observed in in-stent restenosis (RR 1.02, p=0.585) or in-stent thrombosis (RR 1.22, p=0.296). Conclusions: In this large propensity-matched real-world cohort, GLP-1RA therapy was associated with significantly lower risks of MACE, myocardial infarction, stroke, heart failure hospitalization, and repeat coronary revascularization following PCI. These findings suggest that GLP-1RAs may provide important cardiovascular benefits beyond glycemic control and support their potential role as adjunctive secondary prevention therapy in patients undergoing coronary revascularization.