Evidence mapPaperPMID 42188698Full record

ArticleNeurology international2026

Association of Glucagon-like Peptide-1 Receptor Agonist Use with Stroke and Mortality Outcomes in Asymptomatic Intracranial Atherosclerotic Disease: Propensity Score-Matched Real-World Analysis.

Pranjal Rai, Daniel Mandel, Girish Bathla, Vidhi Dhaduk, Radhika Rajeev, Jay Kakadiya, Huanwen Alvin Chen, Hamza A Salim, Ahmed Y Azzam, Muhammed Amir Essibayi and 11 more

Abstract read
In one paragraph

Article in Neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

21 authors.

Pranjal RaiDepartment of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55902, USA.ORCID 0009-0008-3796-8273
Daniel MandelDepartment of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA.
Girish BathlaDepartment of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55902, USA.
Vidhi DhadukShantabaa Medical College and General Hospital, Amreli 365601, Gujarat, India.ORCID 0009-0007-3645-4054
Radhika RajeevDepartment of Radiology, Massachusetts General Hospital, Harvard University, Boston, MA 02114, USA.ORCID 0009-0006-1660-6180
Jay KakadiyaGovernment Medical College, Surat 395001, Gujarat, India.ORCID 0009-0009-2075-6562
Huanwen Alvin ChenDepartment of Neurosurgery, University of Maryland Medical Center, Baltimore, MD 21201, USA.
Hamza A SalimDepartment of Neuroradiology, MD Anderson Medical Center, Houston, TX 77030, USA.
Ahmed Y AzzamDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA.ORCID 0000-0002-4256-0159
Muhammed Amir EssibayiDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Brian ConnollyDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA.
Marc BuzzelliDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA.ORCID 0009-0000-2270-6854
Vivek S YedavalliDepartment of Radiology and Radiological Sciences, Johns Hopkins Medical Center, Baltimore, MD 21205, USA.ORCID 0000-0002-2450-4014
Majid KhanDepartment of Radiology and Radiological Sciences, Johns Hopkins Medical Center, Baltimore, MD 21205, USA.
Adam A DmytriwNuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford OX1 1NF, UK.ORCID 0000-0003-0131-5699
David J AltschulDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Matthew K McIntyreDepartment of Neurosurgery, Oregon Health & Science University, Portland, OR 97239, USA.ORCID 0009-0004-9788-5913
Marco ColasurdoDepartment of Interventional Radiology, Oregon Health & Science University, Portland, OR 97239, USA.
Ajay MalhotraDepartment of Radiology, Yale New Haven Hospital, New Haven, CT 06510, USA.ORCID 0000-0001-9223-6640
Dheeraj GandhiDepartment of Neurosurgery, University of Maryland Medical Center, Baltimore, MD 21201, USA.
Dhairya A LakhaniDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA.

Funding

NIGMS NIH HHS 5U54GM104942-08
6 · The paper itself

Abstract

backgroundAsymptomatic intracranial atherosclerotic arterial stenosis (ICAS) is an underrecognized entity for which vascular risk-factor optimization is the primary management strategy, with no current indication for routine antiplatelet therapy or endovascular intervention for primary stroke prevention. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce major adverse cardiovascular events, including stroke, in high-risk cardiometabolic populations, but their association with outcomes in asymptomatic ICAS is yet to be evaluated. The present study aims to evaluate the association between GLP-1RA use and cerebrovascular outcomes in adults with asymptomatic ICAS. MATERIALS AND

methodsWe used the TriNetX US Collaborative Network (71 healthcare organizations) to identify adults (≥18 years) with ICAS between 1 January 2016 and 31 December 2025, and excluded patients with prior cerebral infarction, intracranial hemorrhage, or cerebrovascular ischemic syndromes. Exposure was defined as initiation of any GLP-1 receptor agonist (lixisenatide, semaglutide, liraglutide, tirzepatide, dulaglutide) during the 6 months before or on the date of index ICAS diagnosis. Outcomes were assessed at 1 year, and included ischemic stroke, all-cause mortality, and a composite of ischemic stroke or mortality. Propensity-score matching (1:1) was performed, including demographics, vascular risk factors, comorbidities, antithrombotics, lipid/diabetes therapies, and cardiometabolic laboratory/physiologic measures.

resultsBefore matching, 1746 GLP-1RA users and 71,792 non-users met inclusion criteria; after matching, 1728 patients remained in each cohort. GLP-1RA use was associated with lower 1-year risk of ischemic stroke (4.40% vs. 6.10%; hazard ratio [HR] 0.70, 95% CI 0.52-0.95;

conclusionsIn this large, propensity-matched cohort of adults with a-ICAS, GLP-1RA use was associated with lower ischemic stroke, all-cause mortality, and composite outcome at 1 year. These findings are hypothesis-generating and require further prospective studies to confirm this observation.

Indexed as

glucagon-like peptide 1 agonistsintracranial atherosclerosismortalitypropensity matchingsemaglutidestroke

Identifiers

PMID42188698
PMCPMC13210162

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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.