# The Role of Glucagon-Like Peptide-1 Receptor Agonists in Post ST-Segment Elevation Myocardial Infarction Care: A Scoping Review

## TL;DR

This review explores how GLP-1RA drugs may help improve heart health after a severe heart attack, suggesting they are safe and could be beneficial.

## Contribution

The paper provides a synthesis of GLP-1RA effects post-STEMI, emphasizing their potential cardioprotective role and safety profile.

## Key findings

- Exenatide improved infarct size, myocardial salvage, and cardiac function in some trials.
- Liraglutide showed benefits in myocardial salvage and biomarker changes without reducing major cardiovascular events.
- Most evidence lacks broad generalizability, highlighting the need for larger trials.

## Abstract

This scoping review synthesizes current evidence on glucagon-like peptide-1 receptor agonist (GLP-1RA) use after ST-elevation myocardial infarction (STEMI), highlighting their potential as adjunctive therapy.

Ten studies investigated exenatide and liraglutide in adults with STEMI, evaluating imaging, clinical, mechanistic, and safety outcomes. GLP-1RA use was safe and well tolerated. Exenatide demonstrated improvements in infarct size, myocardial salvage, and cardiac function, although two trials in broader STEMI populations reported no post-infarction improvements. Across three trials, liraglutide was associated with improved myocardial salvage, infarct size, left ventricular ejection fraction, stroke volume and no-reflow, supported by favorable biomarker changes, but without significant reductions in major cardiovascular events.

While most existing evidence is based on studies with limited generalizability, GLP-1RA use shows promise in improving post-STEMI outcomes. The consistent benefits reported support the need for larger, multicenter trials to clarify GLP-1RA role in cardioprotection and long-term outcomes.