Patients with type 2 diabetes are two to four times more likely to experience cardiovascular events, like a stroke or heart attack. They are more likely to have worse outcomes post-cardiovascular events. Even more alarming, about half of all diabetes-related deaths can be attributed to cardiovascular causes. GLP-1RAs have long been used to help individuals with type 2 diabetes manage blood sugar levels by mimicking the body’s natural hormones, but little is known about their impact on cardiovascular events.
“Due to the novelty of these medications, the research presented at SCAI 2025 Scientific Sessions offers a new perspective for patients and physicians on how GLP-1RAs could improve survival rates for people with or without type 2 diabetes,” said SCAI President James B. Hermiller, MD, MSCAI. “As public interest surrounding these medications increases, these studies offer life-saving treatment potential for patients beyond their current uses for blood sugar level or obesity management.”
GLP-1RAs Use Reduces All-Cause Mortality in Patients with Type 2 Diabetes
Type 2 diabetes increases an individual’s risk of cardiovascular disease. Percutaneous coronary intervention (PCI) is a common solution for treating affected coronary arteries, with over 900,000 interventions performed each year. As the number of PCIs performed annually continues to grow, it’s important to evaluate their effect on patient populations such as those with type 2 diabetes. This study aims to further analyze the role of GLP1-RAs in post-PCI patients with type 2 diabetes.
This retrospective cohort study identified type 2 diabetes patients who underwent a PCI for AMI between 2015 and 2022. 1,552 patients were divided and placed into two groups based on GLP-1RA use. Findings uncovered that GLP-1RA use was associated with a lower risk of all-cause mortality, but there were no significant differences in incidence of in-stent restenosis (the re-narrowing of the coronary artery) or revascularization (repeat PCI or coronary bypass surgery) at three years.
“We were surprised to find there were no major differences in revascularization or in-stent restenosis despite our initial inclination that GLP-1RAs may reduce incidences of these cardiovascular events,” said Moses Sghayyer, MD, Tinsley Harrison Internal Medicine resident at the University of Alabama at Birmingham in Birmingham, Ala., and lead author of the study. “However, since our analysis showed improved all-cause mortality outcomes in our target population, we hope GLP-1 use can be considered in a patient’s treatment plan to improve outcomes.”
Study findings suggest the initiation of additional prospective, randomized studies to validate and extrapolate results.
This abstract is published in the SCAI Abstract Supplement, which appears in SCAI’s official journal, JSCAI. You can access it here: https://doi.org/10.1016/j.jscai.2025.102704.
Non-Diabetic PAD Patients on GLP-1RAs Show Reduced Risk of Serious Cardiovascular Outcomes Compared to Those Without GLP-1RAs
PAD is a condition where the peripheral arteries that carry blood away from the heart to other parts of the body become narrowed or blocked, reducing blood flow to the limbs, often in the legs. This condition increases an individual’s chances of adverse cardiovascular events, with research suggesting patients with PAD have an eight times greater risk of cardiovascular death. Though studies have shown that GLP-1RAs help reduce the likelihood of cardiovascular outcomes in patients with diabetes, this study seeks to investigate if a similar association also exists in the 20% of PAD patients who don’t have diabetes.
The retrospective cohort study analyzed adult PAD patients without diabetes between January 2014 and January 2024. Researchers then compared patients who never received GLP-1RA therapy to those treated with GLP-1RAs for at least one year.
The study matched 8,956 patients to a GLP-1RA and non-GLP-1RA cohort, both consisting predominantly of white females with a mean age of 59 years. The primary outcome was three major adverse cardiovascular events (MACE) – AMI, stroke, and all-cause mortality – which showed significantly reduced odds in the GLP-1RA group. Findings also suggest that GLP-1RA therapy was associated with significantly lower risks of high blood pressure emergency and hospitalization; however, there were no significant differences observed in the outcomes of requiring amputation and revascularization. Additional survival analysis found those who received GLP-1RA therapy had a significantly lower probability of experiencing a MACE (87.53% vs 79.50%).
“PAD presents a serious health crisis that many at-risk patients are completely unaware of,” said lead author of the study Emmanuel Daniel, MD. “We were impressed by the reduction of hospitalization and hypertensive emergency GLP-1RAs can offer this patient population, but surprised by the lack of significant difference in amputation and revascularization procedures. Using this therapy as a tool to treat PAD in patients without diabetes may be a game-changer in terms of reducing morbidity and mortality.”
Prospective controlled clinical trials are warranted to examine the current impact of GLP-1RA on non-diabetic PAD patients.
This abstract is published in the SCAI Abstract Supplement, which appears in SCAI’s official journal, JSCAI. You can access it here: https://doi.org/10.1016/j.jscai.2025.102654.
Tirzepatide Outperforms Semaglutide by Reducing Mortality by 50% in Patients with Diabetes
Tirzepatide, a dual GLP-1/gastric inhibitory polypeptide (GIP) receptor agonist, and semaglutide, a GLP-1RA, are used to treat diabetes. While both medications mimic the natural hormone, GLP-1, that regulates blood sugar and are effective for weight loss, tirzepatide has shown to lead to greater weight loss and improvements in insulin sensitivity.
Individuals with diabetes are more likely to be diagnosed with chronic kidney disease (CKD) and HF because these conditions are closely linked to blood sugar and glucose levels. More specifically, approximately one in three adults with diabetes have CKD. This study aims to uncover which medication has greater efficacy and safety in CKD and HF patients with type 2 diabetes patients. Patients with simultaneous CKD and HF were identified and separated into two cohorts based on semaglutide or tirzepatide use and then monitored for 12 months. The primary endpoint was all-cause mortality, and secondary endpoints were AMI, ischemic stroke, hemorrhagic stroke, atrial fibrillation (A-Fib)/flutter, cardiac arrest, readmission rate, and achievement of HbA1c (blood sugar) levels below 7%.
Researchers identified a total of 33,292 patients with both CKD and HF and placed 4,856 patients into each cohort. Outcomes suggest semaglutide produced poorer outcomes, with a significantly elevated incidence of all-cause mortality (Risk Ratio [RR]: 1.56), AMI (RR: 1.21), ischemic stroke (RR: 1.64, p=0.024) and readmission (RR: 1.15) compared to tirzepatide. No significant differences were observed in the occurrence of hemorrhagic stroke (RR: 1.68), A-Fib/flutter (RR: 1.02), and cardiac arrest (RR: 1.26). Findings also suggest that patients taking tirzepatide were less likely to achieve blood sugar levels under 7% in comparison to those using semaglutide (RR: 0.90).
“While both medications show promise in managing cardiovascular and renal conditions, our team was pleasantly surprised to find significantly better outcomes associated with tirzepatide due to its lower cost, fewer side effects, and greater weight loss effectiveness,” said lead author, Adbul Wali Khan, MD, Internal Medicine Resident at the University of Missouri Kansas City in Kansas City, Mo. “Not only was tirzepatide’s ability to improve survival rates and reduce the chances of other cardiovascular events promising, but the medication also offered superior blood sugar control – a significant advantage for patients with type 2 diabetes.”
This abstract is published in the SCAI Abstract Supplement, which appears in SCAI’s official journal, JSCAI. You can access it here: https://doi.org/10.1016/j.jscai.2025.103372.
A separate study sought to understand STEMI outcomes in patients with type 2 diabetes treated with tirzepatide compared to GLP-1RAs like semaglutide. STEMI is a severe form of heart attack caused by the complete blockage of an artery leading to the heart, in fact, 10% who experience one die within 30 days.
Researchers analyzed data from 1,432 adults (mean age of 61, 48.6% female) with type 2 diabetes who experienced STEMI while taking tirzepatide or GLP-1RAs and continued using the same medication between 2022 and 2023. The primary outcome was all-cause death, with secondary outcomes including major adverse cardiovascular events (MACE), myocardial infarction, stroke, hospitalization, and coronary revascularization.
Tirzepatide was associated with a lower mortality rate at 12 months. Compared to a 4.3% mortality rate in the GLP-1RA group, the tirzepatide group saw a 2.4% mortality rate. While there was a definitive difference in the primary outcome, there was not a significant difference between the two cohorts in secondary outcomes.
Further large-scale randomized controlled trials are warranted to confirm this study's findings.
This abstract is also published in the SCAI Abstract Supplement, which appears in SCAI’s official journal, JSCAI. You can access it here: https://doi.org/10.1016/j.jscai.2025.103367.
Session Details:
“GLP-1 Receptor Agonist Use in Patients with Type 2 Diabetes After Acute Myocardial Infarction and PCI: A Retrospective Cohort Study”
Thursday, May 1, 2025;11:03-11:11 AM ET
Walter E. Washington Convention Center, Hall D, Theater 3
“Impact of GLP-1 Agonist on Cardiovascular Outcomes in Patients with Peripheral Artery Disease without Diabetes: A Propensity Score-Matched Analysis”
Thursday, May 1, 2025;11:11-11:19 AM ET
Walter E. Washington Convention Center, Hall D, Theater 1
“Comparing the effects of Tirzepatide vs. Semaglutide on Long-Term Outcomes in Heart Failure Patients with co-existing chronic kidney disease: A US Cohort Propensity-Matched Study”
Saturday, May 3, 2025; 8:00-8:45 AM ET
Walter E. Washington Convention Center, Exhibit Hall D
“Outcomes of ST-Elevation Myocardial Infarction Among Diabetic Patients on Tirzepatide Versus GLP-1 Receptor Agonists: A Retrospective Study Using Real World Data”
Saturday, May 3, 2025; 8:00-8:45 AM ET
Walter E. Washington Convention Center, Exhibit Hall D
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About Society for Cardiovascular Angiography & Interventions (SCAI)
The Society for Cardiovascular Angiography & Interventions, established in 1978, stands as the primary nonprofit medical society dedicated to representing invasive and interventional cardiology. SCAI's mission is to guide the global interventional cardiovascular community by fostering education, advocacy, research, and upholding standards for quality patient care. For more than 40 years, SCAI has exemplified professional excellence and innovation worldwide, cultivating a reputable community of over 5,000 members committed to advancing medical science and providing life-saving care for individuals, both adults and children, affected by cardiovascular disease. For more information, visit https://scai.org/.
For more information about the SCAI 2025 Scientific Sessions, visit https://scai.org/scai-2025-scientific-sessions. Follow @SCAI on X for the latest heart health news and use #SCAI2025 to follow the latest discussions.
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