Evidence map›Paper›PMID 42006939›Full record

ReviewJournal of central nervous system disease2026

GLP-1 Receptor Agonists in Acute Ischemic Stroke and Secondary Stroke Prevention: A Narrative Review of Preclinical and Clinical Evidence.

Valentini Samanidou, Konstantinos Tsamis, Alexandr Ceasovschih, Theocharis Koufakis, Dimitrios Patoulias, Evangelos C Rizos, Manfreddi Rizzo, Haralampos Milionis, Fotios Barkas

Abstract readReview
In one paragraph

Review in Journal of central nervous system disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Valentini SamanidouDepartment of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Konstantinos TsamisDepartment of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Alexandr CeasovschihFaculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania.
Theocharis KoufakisSecond Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Dimitrios PatouliasSecond Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Evangelos C RizosDepartment of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Manfreddi RizzoSchool of Medicine, Promise Department, University of Palermo, Palermo, Italy.
Haralampos MilionisDepartment of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Fotios BarkasDepartment of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.ORCID https://orcid.org/0000-0002-5940-6895

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute ischemic stroke (AIS) is a leading cause of death and disability. Glucagon-like peptide-1 receptor agonists (GLP-1RA) reduce atherosclerotic events in type 2 diabetes and obesity, and meta-analyses of cardiovascular outcome trials (CVOTs) suggest a modest reduction in incident stroke. Their safety and efficacy within acute AIS pathways remain uncertain. Methods: We conducted a narrative review by searching MEDLINE (PubMed), Cochrane CENTRAL, and ClinicalTrials.gov for studies through January 2026. We included in vitro and animal stroke models, observational studies, randomized controlled trials, and meta-analyses reporting AIS-related outcomes or stroke prevention endpoints with GLP-1RA. Results: Experimental models commonly show reduced infarct volume and improved neurological outcomes, with proposed mechanisms including attenuation of excitotoxicity, apoptosis, oxidative stress, neuroinflammation, and blood-brain barrier disruption, alongside signals of angiogenesis and neurogenesis. Translation is limited by heterogeneity of agents, timing, dosing, and routes, and by uncertainty over direct central nervous system versus systemic mediation. CVOTs and meta-analyses support long-term stroke risk reduction, whereas observational studies and small AIS trials mainly inform feasibility, metabolic control, and safety, with efficacy unproven. Ongoing stroke-dedicated trials should define patient selection, exposure-response relationships, and interactions with thrombolysis or thrombectomy, while prospectively incorporating imaging and biomarker endpoints to test mechanisms. Conclusions: Current evidence does not support routine GLP-1RA use as an acute neuroprotective therapy in AIS in humans. At present, GLP-1RA should be considered primarily for secondary prevention in patients with established indications, pending dedicated stroke trials clarifying acute safety, optimal timing/dosing, interactions with reperfusion therapies, and functional endpoints.

Indexed as

acute ischemic strokecardiovascular benefitsGLP-1 receptor agonistsneuroprotectionrandomized controlled trials

Identifiers

PMID42006939
PMCPMC13087331

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.