Abstract Body: Background and Purpose: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM). We aimed to evaluate the association of GLP-1RA use with clinical outcomes in diabetic patients admitted for acute ischemic stroke (AIS).

Methods: This single-center retrospective study included diabetic patients aged ≥18 years admitted for AIS from 2015-2023. GLP-1RA use was defined as a history of taking GLP-1RA at admission or being prescribed GLP-1RA at discharge. The primary outcome was the incidence of new ischemic stroke within 1 year. Secondary outcomes included functional independence (modified Rankin Scale score 0-2) and mortality at 90 days. Propensity score weighting was used to balance covariates between groups. Logistic regression was used to estimate log odds ratios (LORs) for outcomes.

Results: Of 123 patients, 35 (28%) used GLP-1RA. The GLP-1RA group had lower incidence of new ischemic stroke at 1 year (2.9% vs 6.8%; adjusted LOR -1.13, 95% CI -3.21-0.95, p=0.28) and higher rates of functional independence at 90 days (67% vs 40%; adjusted LOR 2.38, 95% CI -0.12-4.87, p=0.06) compared to the non-GLP-1RA group, but these differences were not statistically significant. Mortality at 90 days was similar between groups (25% vs 26%; adjusted LOR 0.078, 95% CI -1.51-1.67, p=0.92).

Conclusions: In this cohort of diabetic patients admitted for AIS, GLP-1RA use showed trends toward reduced incidence of recurrent stroke and improved functional outcomes, although not statistically significant. Larger prospective studies are needed to further evaluate the potential neuroprotective effects of GLP-1RAs in ischemic stroke.